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Individual

MATTHEW A SPARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
40 DUKE MEDICINE CIR, DURHAM, NC 27710-4000
(919) 684-8111
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
(919) 684-9960
(919) 684-3011

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E-4947
AR
207RN0300X
Nephrology Physician
Primary
2007-00573
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06080016100
QUALCHOICE
AR
05
162843001
AR
01
5N634
BCBS
AR
01
P00351561
RAILROAD MEDICARE
AR
01
T2006094
TRICARE
AR
Enumeration date
09/24/2006
Last updated
05/03/2012
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