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Individual
MARK W MATHEWS
Active
Individual
MARK W MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1388
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0763230001
PALMETTO
—
05
—
084932400
—
FL
01
—
110527
ECPA-EYE MED
—
01
—
1275560435
RAILROAD INDIVIDUAL NPI
FL
01
—
1518098102
RAILROAD GROUP NPI
FL
01
—
19872
INDIVIDUAL BCBS
—
01
—
232279
AMERIGROUP
—
01
—
33801
GROUP BCBS
—
01
—
410022395
RAILROAD GROUP MEMBER PTAN
FL
01
—
410022395
RAILROAD MEDICARE
—
01
—
DN0867
RAILROAD GROUP PTAN
FL
Enumeration date
06/26/2006
Last updated
03/23/2010
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