Matthew Marcello Duhamel

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8581 Issued in MN

Practice address

2104 Northdale Blvd NW
Coon Rapids, MN 55433-3028

Phone

(763) 754-7072

Fax

(763) 754-7077

NPI assigned

Nov 18, 2010

Last updated

Nov 18, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1346542768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 NORTHDALE BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333028",
            "telephone_number": "763-754-7072",
            "fax_number": "763-754-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 NORTHDALE BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333028",
            "telephone_number": "763-754-7072",
            "fax_number": "763-754-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUHAMEL",
        "first_name": "MATTHEW",
        "middle_name": "MARCELLO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-18",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley M Dubord
• Molly Dudley, LMFT
• Due North Wellness Center PLLC
• Kyle Erich Dufek
• Rabira Regassa Dufera, MD
• Kirk Arlan Dulac, D.D.S., M.S.D.
• Brent D. Dumermuth, M.D.
• Dundas Home Care LLC
• Michael Craig Dunham
• Ryan Michael Dunlavey, DDS

• Physical Therapist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.