Provider Demographics
NPI:1063414225
Name:NADLER, MATTHEW ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ERIC
Last Name:NADLER
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 1:7800 COLLEGE BLVD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1870
Mailing Address - Country:US
Mailing Address - Phone:913-491-3999
Mailing Address - Fax:913-491-9309
Practice Address - Street 1:8101 W 135TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-1111
Practice Address - Country:US
Practice Address - Phone:913-491-3999
Practice Address - Fax:913-491-9309
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0429750208VP0014X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100426810AMedicaid
MO207961715Medicaid
KS102329Medicare PIN
KS100426810AMedicaid
MOJ36B962Medicare PIN
KS139B962Medicare PIN
MOJ35B962Medicare PIN