Provider Demographics
NPI:1992678221
Name:MATTHEWS, CEDRIC QUINCY
Entity type:Individual
Prefix:
First Name:CEDRIC
Middle Name:QUINCY
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6115 TUDOR PL
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28356-8049
Mailing Address - Country:US
Mailing Address - Phone:910-261-0958
Mailing Address - Fax:
Practice Address - Street 1:6115 TUDOR PL
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NC
Practice Address - Zip Code:28356-8049
Practice Address - Country:US
Practice Address - Phone:910-261-0958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8529225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant