Provider Demographics
NPI:1902137367
Name:MATTHEWS INFECTIOUS DISEASE SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:MATTHEWS INFECTIOUS DISEASE SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:NORTEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-321-5092
Mailing Address - Street 1:1340 MATTHEWS TOWNSHIP PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5580
Mailing Address - Country:US
Mailing Address - Phone:704-321-5092
Mailing Address - Fax:704-321-5101
Practice Address - Street 1:1340 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:SUITE 102
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5580
Practice Address - Country:US
Practice Address - Phone:704-321-5092
Practice Address - Fax:704-321-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC161990261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center