Individual
MATTHEW ALLEN SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
47964
TN
207RC0000X
Cardiovascular Disease Physician
Primary
47964
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1529796
—
TN
01
—
6062216
BCBS
TN
05
—
7100213920
—
KY
Enumeration date
04/09/2009
Last updated
02/26/2026
Update your record
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