Provider Demographics
NPI:1164417754
Name:NARDONE, MATTHEW ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALLEN
Last Name:NARDONE
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 1:126 MELINDA DR
Mailing Address - Street 2:WINTERSVILLE
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-4049
Mailing Address - Country:US
Mailing Address - Phone:740-266-6218
Mailing Address - Fax:
Practice Address - Street 1:117B THREE SPRINGS DR
Practice Address - Street 2:SUITE 2
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3827
Practice Address - Country:US
Practice Address - Phone:304-723-2494
Practice Address - Fax:304-723-2301
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV765111N00000X
OH3525111N00000X
PADC009025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV765OtherHEALTH PLAN
WV1064663OtherWEST VIRGINIA WORKERS COM
WV662955OtherUNITED HEALTHCARE
WV4701203OtherCARELINK
WVP00202438OtherRAILROAD
WV2203064-000Medicaid
WV777418OtherAETNA
WV1064663OtherWEST VIRGINIA WORKERS COM
WVU89329Medicare UPIN