Individual
MATTHEW BUCHHAMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, PPC
Contact information
Practice address
1841 MADORA AVE, DOUGLAS, WY 82633-3057
(307) 358-2846
(307) 358-5329
Mailing address
1841 MADORA AVE, DOUGLAS, WY 82633-3057
(307) 358-2846
(307) 358-5329
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PPC-878
WY
171M00000X
Case Manager/Care Coordinator
—
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106402907
—
WY
05
—
106402908
—
WY
Enumeration date
09/30/2014
Last updated
02/05/2015
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