Provider Demographics
NPI:1346390457
Name:MATHES, WILLIAM ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ARTHUR
Last Name:MATHES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 COLLEGE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6100
Mailing Address - Country:US
Mailing Address - Phone:207-873-6038
Mailing Address - Fax:207-873-6040
Practice Address - Street 1:32 COLLEGE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6100
Practice Address - Country:US
Practice Address - Phone:207-873-6038
Practice Address - Fax:207-873-6040
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR709111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
013867OtherANTHEM BCBS
M21257OtherCIGNA
5721226OtherAETNA
MAMM0969Medicare ID - Type Unspecified
013867OtherANTHEM BCBS