Provider Demographics
NPI:1619957511
Name:SARVER, MATTHEW DALE (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DALE
Last Name:SARVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 SOUTH CLINTON
Mailing Address - Street 2:
Mailing Address - City:ALBIA
Mailing Address - State:IA
Mailing Address - Zip Code:52531-2659
Mailing Address - Country:US
Mailing Address - Phone:641-932-2939
Mailing Address - Fax:641-932-2106
Practice Address - Street 1:909 SOUTH CLINTON
Practice Address - Street 2:
Practice Address - City:ALBIA
Practice Address - State:IA
Practice Address - Zip Code:52531-2659
Practice Address - Country:US
Practice Address - Phone:641-932-2939
Practice Address - Fax:641-932-2106
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA16203OtherBLUE CROSS BLUE SHIELD
IA0111682Medicaid
U46030Medicare UPIN
IA16203OtherBLUE CROSS BLUE SHIELD