Individual
DR. JUSTIN MATHEW
Active
Individual
DR. JUSTIN MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
57711
KY
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
57711
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300077658
—
IN
01
—
57711
STATE LICENSE
KY
05
—
7100906210
—
KY
01
—
K0000581
MEDICAR
KY
Enumeration date
04/11/2018
Last updated
07/09/2026
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