Basic Information
Provider Information
NPI: 1114103447
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ERBE
FirstName: MATTHEW
MiddleName: C
NamePrefix: DR.
NameSuffix:  
Credential: D.P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4601 PARK RD
Address2: SUITE 300
City: CHARLOTTE
State: NC
PostalCode: 282093239
CountryCode: US
TelephoneNumber: 7043232000
FaxNumber:  
Practice Location
Address1: 1915 RANDOLPH RD
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282071101
CountryCode: US
TelephoneNumber: 7043232000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/16/2008
LastUpdateDate: 09/07/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XP10981NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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