Search › Idaho › 208600000X
Matthew Hagan, M.D
NPI 1477800134 · on the registry since 2012 · sole proprietor
Practice
- Address
- 1855 Madison Ave
Idaho Falls, ID 83404 - Phone
- (208) 881-5351
- Organisation at this address
- Dreamworks Anesthesia Pc
Madison Avenue Surgery Center LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 2
Additional practice sites
- 3500 N Broad St, Philadelphia, PA
- 820 S Wood St Ste 525, Chicago, IL
Registry record
- Primary taxonomy
- 208600000X
208600000X
- Also registered as
- 208600000X
208600000X
2086S0122X - Licence states on file
- IL, PA, ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-06-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho