Individual
MATTHEW JOHN NAEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
225 BALDWIN AVE, CHARLOTTE, NC 28204-3109
(704) 376-1605
Mailing address
225 BALDWIN AVE, CHARLOTTE, NC 28204-3109
(704) 376-1605
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1974
SC
363AS0400X
Surgical Physician Assistant
Primary
0010-11068
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1877PA
—
SC
Enumeration date
08/26/2013
Last updated
11/30/2021
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