Stake, Matthew Steven

Stake, Matthew Steven is an individual health care provider with primary practice located at 250 Fame Ave Ste 206-A , Hanover PA 17331-1587. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Stake, Matthew Steven can be contacted via phone (717) 316-2248.

Contact Information

Primary practice address
250 Fame Ave Ste 206-A Hanover PA 17331-1587
Phone: (717) 316-2248
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X MA059828 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X OA004494 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X OA004494 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MA059828 Pennsylvania

Profile Details

NPI number 1982190377
LBN Legal business name Stake, Matthew Steven
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2018
Last updated Oct 3rd, 2022 - about 4 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 1982190377 NPPES
Pennsylvania MEDICAID 103552557
Pennsylvania Other 727045

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