Individual
MATTHEW EDWARD MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3448 US ROUTE 60, HUNTINGTON, WV 25705-2906
(304) 522-1550
(304) 522-1073
Mailing address
PO BOX 910, HUNTINGTON, WV 25712-0910
(304) 522-1550
(304) 522-1073
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
26482
WV
2085R0202X
Diagnostic Radiology Physician
35.12694
OH
2085R0202X
Diagnostic Radiology Physician
46255
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0139487
—
OH
05
—
3810029831
—
WV
05
—
7100290830
—
KY
Enumeration date
02/27/2009
Last updated
04/18/2024
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