Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MATTHEW WALLNER BROSTROM, PA-C
Active Sole ProprietorMATTHEW WALLNER BROSTROM, PA-C is a Physician Assistant healthcare provider located in MINNEAPOLIS, Minnesota. NPI 1477182160 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · MINNEAPOLIS, MN
Registration Details
- NPI Number
- 1477182160
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 3, 2020 (6.3442403134884 yrs)
- Last Updated
- Oct 17, 2024
- Licenses
-
13679 (MN)8469 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
913 E 26TH ST STE 600MINNEAPOLIS, MN, 554044515Browse MN providers · Browse ZIP 55404
- Phone
- 6127756200
- Fax
- 6127756222
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in MINNEAPOLIS, MN
| Name | Credential | NPI |
|---|---|---|
| KELLY FIDER | PA-C | 1598768434 |
| CHRISTOPHER J GEISLER | MPAS, PA-C | 1942202593 |
| LESLEY ERIN TABER | PA-C | 1154315752 |
| MRS. REBECCA ANN PELKOLA | PA-C | 1245221860 |
| JENNIFER A FLAHERTY | PA | 1598746513 |
| MS. BRIDGET MARY TIERNEY | PA-C | 1932182425 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.