Provider Demographics
NPI:1891866885
Name:MATTHEWS, CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
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 1:904 VANCE ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-2348
Mailing Address - Country:US
Mailing Address - Phone:919-649-6806
Mailing Address - Fax:
Practice Address - Street 1:2501 ATRIUM DR
Practice Address - Street 2:SUITE 400
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6452
Practice Address - Country:US
Practice Address - Phone:919-781-7423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00272452084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC7117OtherMEDCOST
NC0555719OtherUNITED HEALTH CARE
NC54818OtherBCBS OF NC
NC1435715OtherCIGNA
NC4403914OtherAETNA
NCP80705OtherGREAT WEST
NCC81564Medicare UPIN
NC4403914OtherAETNA