Provider Demographics
NPI:1649438433
Name:MATTHEWS-VU MEDICAL GROUP, P.C.
Entity type:Organization
Organization Name:MATTHEWS-VU MEDICAL GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-632-4455
Mailing Address - Street 1:4190 E WOODMEN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-8075
Mailing Address - Country:US
Mailing Address - Phone:719-632-4455
Mailing Address - Fax:719-633-4613
Practice Address - Street 1:4190 E WOODMEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-8075
Practice Address - Country:US
Practice Address - Phone:719-632-4455
Practice Address - Fax:719-633-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty