Provider Demographics
NPI:1508151424
Name:EPPS, MATHEW THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:MATHEW
Middle Name:THOMAS
Last Name:EPPS
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 1:701 GROVE RD
Mailing Address - Street 2:3RD FLOOR SUPPOT TOWER
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-5611
Mailing Address - Country:US
Mailing Address - Phone:864-455-1435
Mailing Address - Fax:864-455-1320
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:3RD FLOOR SUPPOT TOWER
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-5611
Practice Address - Country:US
Practice Address - Phone:864-455-1435
Practice Address - Fax:864-455-1320
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL33836208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery