Provider Demographics
NPI:1255861308
Name:NATURES WAY MEDICINE
Entity Type:Organization
Organization Name:NATURES WAY MEDICINE
Other - Org Name:NATURES WAY MEDICINE, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ANTONI
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:855-420-3627
Mailing Address - Street 1:1224 N KING ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-3232
Mailing Address - Country:US
Mailing Address - Phone:855-420-3627
Mailing Address - Fax:855-696-3299
Practice Address - Street 1:1224 N KING ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-3232
Practice Address - Country:US
Practice Address - Phone:855-420-3627
Practice Address - Fax:855-696-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-00118232084P0800X
PAOS0120692084P0800X, 261QM0850X
DE261QM2500X
261QM2500X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care