Provider Demographics
NPI:1275615825
Name:MATTHEWS, MARTHA S (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:S
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:6200 MAIN ST
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-325-6516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028642E208200000X
NJMA53507208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1241624OtherUNITED HEALTH CARE
NJ2196506Medicaid
NJ3K6090OtherHEALTHNET
NJ020014617OtherRR MEDICARE
NJ22337OtherUNIVERSITY HEALTH PLAN
NJ598889OtherAMERIHEALTH PPO/PA BS
NJP531595OtherOXFORD
NJ1044391OtherHORIZON NJ HEALTH
NJ499944OtherAETNA
NJ598889OtherPA BS HIGHMARK
NJCA0000254OtherAMERICHOICE
NJ0421296000OtherAMERIHEALTH/KEYSTONE/IBC
NJ6973140OtherCIGNA
NJCA0000254OtherAMERICHOICE
NJ598889 AN0Medicare PIN