Provider Demographics
NPI:1760570675
Name:BELDNER, MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BELDNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MATTHEW
Other - Middle Name:ALLAN
Other - Last Name:BELDNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 751874
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1874
Mailing Address - Country:US
Mailing Address - Phone:843-402-5200
Mailing Address - Fax:
Practice Address - Street 1:3510 N HIGHWAY 17 STE 225
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-8233
Practice Address - Country:US
Practice Address - Phone:843-881-5844
Practice Address - Fax:843-789-1791
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23213207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC232135Medicaid
SCAA12197329Medicare PIN
SCI48823Medicare UPIN