Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 2020-00728 | NC |
N | 2080P0204X | Pediatric Emergency Doctor | 35082876 | OH |
NPI | 1184684474 |
---|---|
Provider Name | Rebecca Ruth Hampton Matthews |
First Address | Chapel Hill, NC 27514-4220 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 19/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2520141 | (05) | OH |