Individual
DR. JOHN LYLE MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3725 NATIONAL DR, SUITE 227, RALEIGH, NC 27612-4066
(919) 786-0055
(919) 786-1337
Mailing address
11 COBBLERIDGE CT, DURHAM, NC 27713-9493
(919) 419-0113
(919) 786-1337
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
95-01331
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225G
BCBS
—
05
—
891225G
—
NC
Enumeration date
02/02/2007
Last updated
04/20/2008
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