Provider Demographics
NPI:1477528966
Name:REEVES, MATTHEW FONTAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:FONTAINE
Last Name:REEVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1156 15TH ST NW
Mailing Address - Street 2:SUITE 700
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-1704
Mailing Address - Country:US
Mailing Address - Phone:202-417-1454
Mailing Address - Fax:202-478-1976
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE 1200
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-321-3300
Practice Address - Fax:301-652-1045
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD423665174400000X
DCMD038268207V00000X
MDD0069810207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC061888400Medicaid
MD5240018-01Medicaid
PA101004366Medicaid
DC061888400Medicaid
MD5240018-01Medicaid