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Contact Information

MATTHEW D PROBST, PA-C
2020 7TH ST
LAS VEGAS, NM87701-4958
 Phone: 505-434-0119
 Fax: 877-553-1272
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MATTHEW D PROBST · (Male)

NPI Number 1053305474
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/31/2005
Last updated 02/23/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • NM License # PA2003-0043
  • NM Medicaid 60950277
  • NM Other NM400319 MEDICARE PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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