Provider Demographics
NPI:1922357565
Name:MATTHEWS INTERNAL MEDICINE PLLC
Entity Type:Organization
Organization Name:MATTHEWS INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SANGMUAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-246-3936
Mailing Address - Street 1:1663 CAMPUS PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-5581
Mailing Address - Country:US
Mailing Address - Phone:704-246-3936
Mailing Address - Fax:
Practice Address - Street 1:1663 CAMPUS PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5581
Practice Address - Country:US
Practice Address - Phone:704-246-3936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MATTHEWS INTERNAL MEDICINE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101490207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty