Provider Demographics
NPI:1770544751
Name:SHAWVER-MATTHEWS, SUSAN E (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:SHAWVER-MATTHEWS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2038
Mailing Address - Country:US
Mailing Address - Phone:508-898-2338
Mailing Address - Fax:508-366-9938
Practice Address - Street 1:106 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1417
Practice Address - Country:US
Practice Address - Phone:508-898-2338
Practice Address - Fax:508-366-9938
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA48564208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherTHREE RIVERS
B28053OtherBLUE SHIELD INDEMNITY
042472266OtherONE HEALTH PLAN
5621538OtherCIGNA HEALTH PLAN
784190OtherMVP HEALTH CARE
B28053OtherBLUE CARE ELECT
0186457OtherMEDICAID WELFARE
2039843OtherFIRST HEALTH
B28053OtherMEDICARE B
9900092OtherFALLON COMMUNITY HEALTH
042472266OtherHEALTHCARE VALUE MGMT
27058OtherHEALTHY START
7503630OtherAETNA US HEALTHCARE
MA0186457Medicaid
AA1255OtherHARVARD PILGRIM HEALTH
B28053OtherBLUE SHIELD HMO BLUE
042472266OtherPRIVATE HEALTHCARE SYSTEM
27058OtherCHILDRENS MEDICAL SECURIT
9900092OtherFALLON COMMUNITY HEALTH
AA1255OtherHARVARD PILGRIM HEALTH