Individual
MATTHEW T. HERREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Mailing address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS8910
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009924355
—
AL
05
—
131511
—
AL
05
—
267431900
—
FL
01
—
59168368
BLUECROSS & BLUESHIELD
AL
01
—
592-15448
BLUE CROSS BLUE SHIELD
AL
01
—
79033
BLUECROSS & BLUESHIELD
FL
01
—
C400
HEALTH FIRST NETWORK
FL
01
—
P000048462
RAILROAD MEDICARE
FL
Enumeration date
08/10/2005
Last updated
11/14/2011
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