Provider Demographics
NPI:1730128976
Name:MATTEO, CRAIG MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:MATTHEW
Last Name:MATTEO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 S FIFTH ST
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-3240
Mailing Address - Country:US
Mailing Address - Phone:919-563-0000
Mailing Address - Fax:919-563-0063
Practice Address - Street 1:941 S FIFTH ST
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-3240
Practice Address - Country:US
Practice Address - Phone:919-563-0000
Practice Address - Fax:919-563-0063
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085GXMedicaid
NC2454494AMedicare ID - Type Unspecified
NC89085GXMedicaid