Provider Demographics
NPI:1871110635
Name:SHEM, MATTHEW (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:SHEM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4740 FLINTRIDGE DR STE 220
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4273
Mailing Address - Country:US
Mailing Address - Phone:719-208-4314
Mailing Address - Fax:719-960-2192
Practice Address - Street 1:4740 FLINTRIDGE DR STE 220
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4273
Practice Address - Country:US
Practice Address - Phone:719-208-4314
Practice Address - Fax:719-960-2192
Is Sole Proprietor?:No
Enumeration Date:2020-06-28
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6479111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology