Individual
MATTHEW W PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2406 BLUE RIDGE RD, RALEIGH, NC 27607-6678
(919) 954-4160
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
(919) 620-4467
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101238988
VA
207Q00000X
Family Medicine Physician
Primary
2012-01670
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302198
ANTHEM
VA
01
—
C06695
GROUP PTAN
VA
Enumeration date
12/06/2006
Last updated
02/01/2013
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