Provider Demographics
NPI:1053310334
Name:GERMINI, MATTHEW J (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:GERMINI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RAINS ST
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-7854
Mailing Address - Country:US
Mailing Address - Phone:336-985-3500
Mailing Address - Fax:877-641-6249
Practice Address - Street 1:101 RAINS ST
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-7854
Practice Address - Country:US
Practice Address - Phone:336-985-3500
Practice Address - Fax:877-641-6249
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085FHOtherBLUE CROSS/ BLUE SHIELDNC
NC89085FHMedicaid
NC9212188OtherPHCS
NC48052OtherPARTNERS/MEDICARE CHOICE
NC7710285OtherAETNA
NC2454229Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
NC89085FHMedicaid