Koch, Matthew J

Koch, Matthew J is an individual health care provider with primary practice located at 4550 Memorial Dr Ste 280 , Belleville IL 62226-5372. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Koch, Matthew J can be contacted via phone (618) 767-3235.

Contact Information

Primary practice address
4550 Memorial Dr Ste 280 Belleville IL 62226-5372
Phone: (618) 767-3235
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 2002009358 Missouri
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 036121947 Illinois

Profile Details

NPI number 1962420448
LBN Legal business name Koch, Matthew J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Mar 22nd, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962420448 NPPES
Missouri MEDICAID 205799000

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