Provider Demographics
NPI:1710980719
Name:MATHEWS, RAYMOND ERIC (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:ERIC
Last Name:MATHEWS
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 1:116 S GEORGE ST STE 301
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-1443
Mailing Address - Country:US
Mailing Address - Phone:717-801-4821
Mailing Address - Fax:717-854-0377
Practice Address - Street 1:1230 HIGH ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1127
Practice Address - Country:US
Practice Address - Phone:717-632-9052
Practice Address - Fax:717-632-2388
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2019-02-14
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
PAMD036880E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232775107OtherYORK HEALTH
PA991631OtherKEYSTONE
PA655692OtherHIGHMARK BLUE SHIELD-WMG
MD532980OtherMARYLAND BCBS CAREFIRST
PA839652OtherMAMSI
PA1187960Medicaid
PA8120184OtherCIGNA
PA416128OtherUPMC-WMG
MD5907OtherMARYLAND-BLUE SHIELD
PA839652OtherMAMSI
PA655692OtherHIGHMARK BLUE SHIELD-WMG
PA199197YUNMMedicare PIN
MD5907OtherMARYLAND-BLUE SHIELD