Basic Information
Provider Information
NPI: 1215002654
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOBERG
FirstName: MATTHEW
MiddleName: JAMES
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 300 SOUTH ARLINGTON AVENUE
Address2:  
City: RENO
State: NV
PostalCode: 895012002
CountryCode: US
TelephoneNumber: 7753481900
FaxNumber: 7753481904
Practice Location
Address1: 235 WEST 6TH STREET
Address2: SAINT MARY'S REGIONAL MEDICAL CENTER
City: RENO
State: NV
PostalCode: 895034548
CountryCode: US
TelephoneNumber: 7757703000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/21/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X7439NVY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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