Provider Demographics
NPI:1629287479
Name:CAREY, MATTHEW B (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:B
Last Name:CAREY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:325 MAINE STREET
Mailing Address - Street 2:MSO LIBRARY
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-7700
Mailing Address - Country:US
Mailing Address - Phone:785-505-2988
Mailing Address - Fax:785-505-5228
Practice Address - Street 1:4525 W 6TH ST STE 100
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-7700
Practice Address - Country:US
Practice Address - Phone:785-505-5160
Practice Address - Fax:785-505-5282
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-330972084P0800X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110661023OtherMEDICARE PTAN
KS200566730CMedicaid