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Individual
THOMAS MATHEWS
Active
Individual
THOMAS MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME79158
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258295300
—
FL
01
—
421557400
TAX ID
FL
01
—
ME79158
FLORIDA STATE MEDICAL LIC
FL
Enumeration date
01/17/2006
Last updated
07/08/2007
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