Individual
MATTHEW G CHEADLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3215 N NORTH HILLS BLVD, FAYETTEVILLE, AR 72703
(479) 463-1000
Mailing address
PO BOX 879, FAYETTEVILLE, AR 72702-0879
(479) 713-7115
(479) 713-7186
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
C6807
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50407
BLUE
AR
Enumeration date
05/18/2006
Last updated
07/08/2007
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