Provider Demographics
NPI:1558340521
Name:MATTHEWS, DAVID PHILIP (PHD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PHILIP
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6216A
Mailing Address - Street 2:1 PINCKNEY BLVD NAVAL HOSPITAL BEAUFORT ATTN PROFESSION
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6148
Mailing Address - Country:US
Mailing Address - Phone:843-228-5577
Mailing Address - Fax:843-228-5196
Practice Address - Street 1:1 PINCKNEY BLVD
Practice Address - Street 2:NAVAL HOSPITAL BEAUFORT ATTN PROFESSION AFFAIRS COORDIN
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6122
Practice Address - Country:US
Practice Address - Phone:843-228-5577
Practice Address - Fax:843-228-5196
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000OTHMedicare UPIN