Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | D0058462 | MD |
NPI | 1033137948 |
---|---|
Provider Name | Earl Craig Matthews |
First Address | Towson, MD 21204-7736 |
Second Address | Towson, MD 21204-7736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 13/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
718902800 | (05) | MD |
F97580 | (02) |