Provider Demographics
NPI:1467465591
Name:MATHEWS, URLIN DANIEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:URLIN
Middle Name:DANIEL
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GRANTSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26147-7100
Mailing Address - Country:US
Mailing Address - Phone:304-354-9244
Mailing Address - Fax:304-354-9323
Practice Address - Street 1:186 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GRANTSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26147-7100
Practice Address - Country:US
Practice Address - Phone:304-354-9244
Practice Address - Fax:304-354-9323
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV01172363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVQ62308Medicare UPIN
WVMAPA78951Medicare ID - Type Unspecified