Provider Demographics
NPI:1871536920
Name:MCBRIDE, MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3366 NW EXPRESSWAY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4462
Mailing Address - Country:US
Mailing Address - Phone:405-702-1300
Mailing Address - Fax:405-702-1280
Practice Address - Street 1:5015 N PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8891
Practice Address - Country:US
Practice Address - Phone:405-767-6630
Practice Address - Fax:405-767-1176
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19881207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100042450AMedicaid
OK100042450AMedicaid
OKOK400012Medicare PIN
OKOK400012Medicare PIN