Provider Demographics
NPI:1629238860
Name:DAVIS, MATTHEW JARED (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JARED
Last Name:DAVIS
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 1:1000 RTE 35 STE 101
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-2609
Mailing Address - Country:US
Mailing Address - Phone:732-629-9699
Mailing Address - Fax:732-724-9802
Practice Address - Street 1:1000 STATE ROUTE 35 STE 101
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2609
Practice Address - Country:US
Practice Address - Phone:732-629-9699
Practice Address - Fax:732-724-9802
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA090560002084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine