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Organization

HUNTINGTON MEDICAL GROUP PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN C. MATHEW M.D. (OWNER)
(260) 356-4005
Entity
Organization

Contact information

Practice address
1601 N JEFFERSON ST, HUNTINGTON, IN 46750-1404
(260) 356-4005
(260) 356-3501
Mailing address
1601 N JEFFERSON ST, HUNTINGTON, IN 46750-1404
(260) 356-4005
(260) 356-3501

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01035103A
IN
207R00000X
Internal Medicine Physician
01053659A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100138210A
IN
01
110016196
TRAVELERS MEDICARE
IN
01
110247671
TRAVELERS MEDICARE
IN
05
200926830
IN
Enumeration date
10/31/2007
Last updated
10/13/2010
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