Matthew Paul Bakkum, DPT
Individual provider Active NPI Physical Therapist · Bismarck, ND
NPI 1740529403 · NPPES record last updated Jan 31, 2013
Key facts
- NPI
- 1740529403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1724 (ND)
- Practice address
- 1000 Tacoma Ave Ste 500
Bismarck, ND 58504-7093 - Phone
- (701) 751-3001
- NPI assigned
- Jan 31, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1724 | ND | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1724 | ND | Yes |
Addresses
Primary practice location
1000 Tacoma Ave Ste 500
Bismarck, ND 58504-7093
Mailing address
1809 Valley Dr
Bismarck, ND 58503-0196
Phone (701) 400-9793
Other providers in Bismarck, ND
- Biron D. Baker
- Carly Jean Baker
- Katherine Baker
- Stephanie Ann Baker
- Teliea Kateri Baker
- Balance Medical, LLC
- Balanced Health Chiropractic & Wellness, PC
- Caleb Josef Balas
- Tamara Marie Balerud
- Erin Elizabeth Bales
All providers in Bismarck, ND · Physical Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2013. 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.