Provider Demographics
NPI:1164825410
Name:MATTHEWS, NIGEL
Entity Type:Individual
Prefix:
First Name:NIGEL
Middle Name:
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 1:149 BRAUER HL
Mailing Address - Street 2:CB 7450
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7450
Mailing Address - Country:US
Mailing Address - Phone:919-537-3944
Mailing Address - Fax:919-537-3407
Practice Address - Street 1:149 BRAUER HL
Practice Address - Street 2:CB 7450
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-537-3944
Practice Address - Fax:919-537-3407
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01451223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery