Individual
KATHERINE MARIE MATTHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
800 N A ST, EASLEY, SC 29640-2144
(864) 855-0001
(864) 855-5030
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36690
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366990
—
SC
01
—
SCB281
MEDICARE
SC
Enumeration date
06/06/2014
Last updated
06/03/2021
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