Provider Demographics
NPI:1801327101
Name:WORKMAN, MATTHEW RYAN (MD, MPH, FAAP)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:RYAN
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:MD, MPH, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 PEERLESS XING NW STE 100
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3785
Mailing Address - Country:US
Mailing Address - Phone:423-339-5656
Mailing Address - Fax:423-339-8889
Practice Address - Street 1:1060 PEERLESS XING NW STE 100
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3785
Practice Address - Country:US
Practice Address - Phone:423-339-5656
Practice Address - Fax:423-339-8889
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN60128208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty