MATTHEW E SHAMBAUGH (NPI# 1700888617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700888617 |
Entity Type | Individual |
Full Name | MATTHEW E SHAMBAUGH |
Credential | MD |
Practice Address |
7920 W Jefferson Blvd Ste 200 Fort Wayne IN 46804-4166 |
Practice Telephone | 2604907111 |
Practice Fax Number | 2604902286 |
Mailing Telephone | 2604907111 |
Mailing Fax Number | 2604902286 |
Enumeration Date | 2005-08-10 |
Last Update Date | 2017-04-18 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208200000X | Plastic Surgery | 01038077A | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | MEDICARE RAILROAD | 240007527 | 01 |
IN | 100372030 | 05 | |
MI | 104366811 | 05 | |
OH | 0852733 | 05 |
Street Address |
7920 W JEFFERSON BLVD STE 200 |
City | FORT WAYNE |
State | IN |
Zip Code | 46804-4166 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013201995 | Reid Robert Pflueger | Plastic Surgery | 7920 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804 | 2011-06-08 |
1194701664 | Summit Plastic Surgery, PC | Plastic Surgery | 7920 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-4166 | 2005-12-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
Find all providers in zip 46804 |
Taxonomy Code | 208200000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Plastic Surgery |
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730277583 | Fort Wayne Dermatology Cons. Inc. | Plastic Surgery | 7881 Carnegie Blvd, Fort Wayne, IN 46804-5792 | 2006-10-10 |
1508867656 | Brian J Lee | Plastic Surgery | 7910 W Jefferson Blvd Ste 212, Fort Wayne, IN 46804-4159 | 2005-08-10 |
1124029079 | Guy Gerald Crevecoeur | Plastic Surgery | 11141 Parkview Plaza Dr Ste 300, Fort Wayne, IN 46845-1715 | 2005-08-02 |
1881968279 | Aspire Plastic Surgery LLC | Plastic Surgery | 7910 W Jefferson Blvd Ste 212, Fort Wayne, IN 46804-4159 | 2012-03-02 |
1013201995 | Reid Robert Pflueger | Plastic Surgery | 7920 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804 | 2011-06-08 |
1477622934 | Michael Robert Davis | Plastic Surgery | 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 | 2006-11-07 |
1275624686 | Plastic Surgery Innovations, P.C. | Plastic Surgery | 10215 Auburn Park Dr, Suite B, Fort Wayne, IN 46825-2387 | 2006-09-28 |
1033120969 | Robert Nicholas Severinac | Plastic Surgery | 10020 Dupont Circle Ct, Suite 100, Fort Wayne, IN 46825-1620 | 2006-08-09 |
1407888589 | James R. Miller | Plastic Surgery | 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845-1713 | 2006-07-07 |
1194701664 | Summit Plastic Surgery, PC | Plastic Surgery | 7920 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-4166 | 2005-12-16 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46804 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.