Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1646 | MD |
N | 222Z00000X | Podiatrist | 1646 | MD |
N | 213ES0131X | Foot Surgery | 103301247 | VA |
Y | 213ES0131X | Foot Surgery | 1646 | MD |
NPI | 1396164372 |
---|---|
Provider Name | Dr. Michael Matthews |
First Address | Bethesda, MD 20814-3138 |
Second Address | Bethesda, MD 20814-3138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 17/11/2020 |