Provider Demographics
NPI:1700163391
Name:ALMEIDA, MATTHEW D (BOCO, LO, CPED)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:D
Last Name:ALMEIDA
Suffix:
Gender:M
Credentials:BOCO, LO, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 PALMYRA RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1574
Mailing Address - Country:US
Mailing Address - Phone:229-430-9778
Mailing Address - Fax:229-430-1347
Practice Address - Street 1:1919 PALMYRA RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1574
Practice Address - Country:US
Practice Address - Phone:229-430-9778
Practice Address - Fax:229-430-1347
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP1600X, 224L00000X
GA110222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist