Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME130656 | FL |
N | 207XS0106X | Orthopaedic Hand Surgeon | ME130656 | FL |
NPI | 1235498460 |
---|---|
Provider Name | Christopher John Matthews |
First Address | Daytona Beach, FL 32117-4611 |
Second Address | Daytona Beach, FL 32117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2012 |
Last Update Date | 09/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023537000 | (05) | FL |