Provider Demographics
NPI:1144226853
Name:DAIRMAN, MATTHEW C (DPM, MS, FACFAS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:C
Last Name:DAIRMAN
Suffix:
Gender:M
Credentials:DPM, MS, FACFAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4507
Mailing Address - Country:US
Mailing Address - Phone:757-934-0768
Mailing Address - Fax:757-925-1901
Practice Address - Street 1:171 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4507
Practice Address - Country:US
Practice Address - Phone:757-934-0768
Practice Address - Fax:757-925-1901
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300887213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA199840OtherANTHEM BC/BS
VA3125477OtherMAMSI
VA010316057Medicaid
VA64460OtherOPTIMA NUMBER
5966790001Medicare NSC
VA199840OtherANTHEM BC/BS
VA3125477OtherMAMSI
VAU95144Medicare UPIN