Provider Demographics
NPI:1497728174
Name:ACAMPORA, MATTHEW D (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:D
Last Name:ACAMPORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8035 PROVIDENCE RD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-9716
Mailing Address - Country:US
Mailing Address - Phone:704-366-0080
Mailing Address - Fax:704-366-0779
Practice Address - Street 1:8035 PROVIDENCE RD
Practice Address - Street 2:SUITE 315
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-9716
Practice Address - Country:US
Practice Address - Phone:704-366-0080
Practice Address - Fax:704-366-0779
Is Sole Proprietor?:No
Enumeration Date:2006-02-11
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400402207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1062COtherBCBS
NC891062CMedicaid
NC1062COtherBCBS
NC2236722BMedicare ID - Type Unspecified