Individual
MR. MATTHEW THOMAS DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2893 STURGIS RD, ROCK HILL, SC 29730-6607
(803) 366-9090
(803) 366-9141
Mailing address
2893 STURGIS RD, ROCK HILL, SC 29730-6607
(803) 366-9090
(803) 366-9141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03548
NC
363A00000X
Physician Assistant
Primary
3345
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295993376
—
AZ
05
—
1629236716
—
AZ
05
—
1780614008
—
AZ
05
—
1871523191
—
AZ
Enumeration date
11/30/2005
Last updated
07/31/2012
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