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Individual

MATTHEW G HOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
791 JONESTOWN RD, WINSTON SALEM, NC 27103-1252
(336) 716-4551
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
200301472
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10069131
VA
01
135XF
BCBS
NC
05
2007390000
WV
01
7655636
AETNA
01
803863
PARTNERS
NC
05
89135XF
NC
01
D1523
MEDCOST
NC
Enumeration date
12/02/2005
Last updated
09/03/2015
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