Individual
DR. MICHAEL D MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
775 WAUKEGAN RD, SUITE 200, DEERFIELD, IL 60015-4342
(800) 317-0711
(800) 434-7113
Mailing address
5512 W SUDBURY DR, MUNCIE, IN 47304-9520
(765) 747-1260
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002518A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000371058
ANTHEM
IN
05
—
200511800
—
IN
Enumeration date
01/12/2006
Last updated
09/09/2014
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