Provider Demographics
NPI:1649241290
Name:MATTHEWS, JAMES P (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:MATTHEWS
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 1:301 STEEPLE CHASE DR STE 108
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4050
Mailing Address - Country:US
Mailing Address - Phone:443-295-7215
Mailing Address - Fax:877-902-7671
Practice Address - Street 1:301 STEEPLE CHASE DR STE 108
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4050
Practice Address - Country:US
Practice Address - Phone:443-295-7215
Practice Address - Fax:877-902-7671
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BM8148593OtherDEA
MDH80418Medicare UPIN
491466Medicare ID - Type Unspecified