Provider Demographics
NPI:1346387826
Name:ASHBY, MATTHEW MCCRAY (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:MCCRAY
Last Name:ASHBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 COLUMBIA AVE STE 2E
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-3530
Mailing Address - Country:US
Mailing Address - Phone:219-595-0043
Mailing Address - Fax:
Practice Address - Street 1:9250 COLUMBIA AVE STE 2E
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3530
Practice Address - Country:US
Practice Address - Phone:219-595-0043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361644122084P0804X
IN01086800A2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry