Provider Demographics
NPI:1467741306
Name:MATHEW, MATTHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEN
Middle Name:
Last Name:MATHEW
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 1:6282 LINTON BLVD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6416
Mailing Address - Country:US
Mailing Address - Phone:561-955-6400
Mailing Address - Fax:561-955-6618
Practice Address - Street 1:701 NW 13TH ST FL 2
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2305
Practice Address - Country:US
Practice Address - Phone:561-955-6400
Practice Address - Fax:561-955-6618
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267239207R00000X, 207RX0202X
FL145836207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine