Provider Demographics
NPI:1336224559
Name:MATTHEWS, ANDREW ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ROBERT
Last Name:MATTHEWS
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 1:1909 S CANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-6107
Mailing Address - Country:US
Mailing Address - Phone:704-938-1400
Mailing Address - Fax:704-938-5892
Practice Address - Street 1:1909 S CANNON BLVD
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-6107
Practice Address - Country:US
Practice Address - Phone:704-938-1400
Practice Address - Fax:704-938-5892
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2908111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085AXOtherNC BCBS
NC1972575314OtherNC CHIRO FACILITY NPI#
NC89085AXMedicaid
NC085AXOtherNC BCBS
NCU85180Medicare UPIN