Individual
SPENCER MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 2ND LOOP RD, FLORENCE, SC 29505-2820
(864) 512-1475
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 777-9460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
52657
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
527264
—
SC
Enumeration date
05/01/2018
Last updated
07/07/2021
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