Individual
DR. MATTHEW JUSTIN TODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
975 E 3RD ST, CHATTANOOGA, TN 37403-2103
(423) 778-3274
(423) 778-2255
Mailing address
PO BOX 70, CHATTANOOGA, TN 37401-0070
(423) 778-3274
(423) 778-2255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35973
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841209632
NPI
TN
01
—
3881325
WELLCARE
TN
05
—
3881325
—
TN
01
—
4134582
BLUE SHIELD
TN
01
—
P00371032
RR MEDICARE
TN
01
—
TN0100
JDEERE
TN
Enumeration date
08/08/2006
Last updated
04/09/2008
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