Provider Demographics
NPI:1881773364
Name:MATCHETT, STEPHEN CHARLES (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:CHARLES
Last Name:MATCHETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 106B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6298
Mailing Address - Country:US
Mailing Address - Phone:610-402-9373
Mailing Address - Fax:610-402-9384
Practice Address - Street 1:1247 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 106B
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6298
Practice Address - Country:US
Practice Address - Phone:610-402-9373
Practice Address - Fax:610-402-9384
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055898L207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
712742FSDMedicare ID - Type Unspecified
E62429Medicare UPIN