Individual
MATTHEW D GARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
407 S. 19TH ST, BLAIR, NE 68008
(402) 533-2223
(531) 301-6272
Mailing address
407 S. 19TH ST, BLAIR, NE 68008
(402) 533-2223
(531) 301-6272
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
900
NE
363AM0700X
Medical Physician Assistant
900
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38785
BLUE CROSS BLUE SHIELD
NE
Enumeration date
11/29/2006
Last updated
03/10/2022
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