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Individual

DR. MATTHEW T CADDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
800 N DUPONT BLVD, MILFORD, DE 19963-1019
(302) 672-2319
(302) 430-5448
Mailing address
800 N DUPONT BLVD, MILFORD, DE 19963-1019
(302) 672-2319
(302) 430-5448

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C2-0023888
DE
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
218076
NY
2083X0100X
Occupational Medicine Physician
218076-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02444484
NY
01
1T6630
MEDICARE PTAN
DE
01
5016G1
EMPIRE BC.BS
NY
01
7132503
AETNA
NY
Enumeration date
07/18/2006
Last updated
04/07/2022
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