Matthew Gray, IDMT
Individual provider Active NPI Independent Duty Medical Technicians · Eielson Afb, AK
NPI 1104393446 · NPPES record last updated Oct 24, 2018
Key facts
- NPI
- 1104393446
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Medical Technicians 1710I1003X
- Practice address
- 2630 Central Ave
Eielson Afb, AK 99702-2301 - Phone
- (931) 220-2210
- NPI assigned
- Oct 24, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Yes |
Addresses
Primary practice location
2630 Central Ave
Eielson Afb, AK 99702-2301
Mailing address
2630 Central Ave
Eielson Afb, AK 99702-2301
Other providers in Eielson Afb, AK
- Holly Vokoun Ellenberger
- Michelle Marie Ely
- Ashley Noelle Franz
- Kathleen Frost
- Peter Fullmer
- Brendan James Hall
- John Frederick Hamilton Jr.
- Nathan Hamilton
- Whitney Neal Hasbrouck
- Kaleb Hatfield
All providers in Eielson Afb, AK · Independent Duty Medical Technicians in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.