Provider Demographics
NPI:1902891153
Name:FLOOD, MATTHEW JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOHN
Last Name:FLOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-2717
Mailing Address - Country:US
Mailing Address - Phone:864-429-8029
Mailing Address - Fax:864-429-3515
Practice Address - Street 1:801 W MAIN ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-2717
Practice Address - Country:US
Practice Address - Phone:864-429-8029
Practice Address - Fax:864-429-3515
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16085207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00447334OtherRAILROAD MEDICARE
SCP00447334OtherMEDICARE RAILROAD CARRIER
SC160854Medicaid
SC7983Medicare PIN
SC160854Medicaid
SC5050Medicare PIN
SC8887Medicare PIN