Individual
DR. BRANDY R MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 W 10TH ST, 4TH FLOOR, INDIANAPOLIS, IN 46202-2859
(317) 630-7979
(317) 630-2668
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01064983A
IN
2084N0400X
Neurology Physician
A92389
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A923890
—
CA
05
—
200899010
—
IN
01
—
P01002410
RAILROAD MEDICARE PTAN
IN
Enumeration date
04/14/2006
Last updated
02/18/2014
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