Individual
MR. EDWIN KEITH MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2422 DANVILLE ROAD, SUITE E, DECATUR, AL 35603
(256) 355-9040
(256) 355-9048
Mailing address
PO BOX 5750, DECATUR, AL 35601
(256) 355-9040
(256) 355-9048
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00025048
AL
207Q00000X
Family Medicine Physician
Primary
25048
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51513850
BLUE CROSS BLUE SHIELD
—
05
—
529402090
—
AL
05
—
630105060
—
AL
Enumeration date
07/18/2006
Last updated
10/01/2020
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