Provider Demographics
NPI:1407887268
Name:MATTHEWS, GRAHAM B (MD)
Entity Type:Individual
Prefix:DR
First Name:GRAHAM
Middle Name:B
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:900 TOWNE LAKE PKWY
Mailing Address - Street 2:STE 210
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-1602
Mailing Address - Country:US
Mailing Address - Phone:770-592-2300
Mailing Address - Fax:770-592-2040
Practice Address - Street 1:900 TOWNE LAKE PKWY
Practice Address - Street 2:STE 210
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-1602
Practice Address - Country:US
Practice Address - Phone:770-592-2300
Practice Address - Fax:770-592-2040
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2020-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA041883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003149755IMedicaid
GA003149755JMedicaid
GA003149755MMedicaid
GA003149755JMedicaid
GA003149755IMedicaid