Provider Demographics
NPI:1174017545
Name:MATHEWS, JARED (MD)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:925 BISHOP WALSH RD STE 4
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1845
Mailing Address - Country:US
Mailing Address - Phone:301-777-5326
Mailing Address - Fax:301-777-0325
Practice Address - Street 1:925 BISHOP WALSH RD STE 4
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1845
Practice Address - Country:US
Practice Address - Phone:301-777-5326
Practice Address - Fax:301-777-0325
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT216665207Q00000X
MDD0091284207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine