Provider Demographics
NPI:1447075817
Name:REDMAN, MATTHEW D
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:REDMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23204 STATE ROUTE 125
Mailing Address - Street 2:
Mailing Address - City:BLUE CREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45616-9761
Mailing Address - Country:US
Mailing Address - Phone:740-438-9152
Mailing Address - Fax:
Practice Address - Street 1:23204 STATE ROUTE 125
Practice Address - Street 2:
Practice Address - City:BLUE CREEK
Practice Address - State:OH
Practice Address - Zip Code:45616-9761
Practice Address - Country:US
Practice Address - Phone:740-438-9152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide