Individual
DR. MATTHEW BACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
56873
WI
2085R0202X
Diagnostic Radiology Physician
Primary
A125819
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A1258190
BS OF CA
CA
05
—
1669653861
—
CA
Enumeration date
11/16/2007
Last updated
12/30/2013
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