Individual
MR. JACOB MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 759-5800
Mailing address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 759-5800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2020-04029
NC
207L00000X
Anesthesiology Physician
90685
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/20/2013
Last updated
10/20/2023
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