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Individual

MATTHEW T MATTHEW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2525 COURT DRIVE, GASTONIA, NC 28054
(704) 834-2000
Mailing address
PO BOX 12845, GASTONIA, NC 28052
(704) 834-2825
(704) 866-7853

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
010253189
VA
207L00000X
Anesthesiology Physician
Primary
9800629
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12224
BLUE CROSS
NC
05
7912224
NC
Enumeration date
07/11/2006
Last updated
11/25/2013
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