Provider Demographics
NPI:1932178514
Name:NADAUD, MATTHEW C (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:C
Last Name:NADAUD
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 1:1422 OLD WEISGARBER RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1293
Mailing Address - Country:US
Mailing Address - Phone:865-558-4400
Mailing Address - Fax:865-558-4471
Practice Address - Street 1:1422 OLD WEISGARBER RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2674
Practice Address - Country:US
Practice Address - Phone:865-558-4400
Practice Address - Fax:865-558-4471
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35164207XS0114X
TNMD35164207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3862733Medicaid
P00791748OtherRAILROAD MEDICARE
TN200046166OtherRAILROAD MEDICARE
TN4012120OtherBLUE CROSS BLUE SHIELD
TNTN01A3OtherJOHN DEERE HEALTHCARE
TNTN01A4OtherJOHN DEERE HEALTHCARE
TN3862733Medicaid
TN103I204501Medicare PIN
TNTN01A3OtherJOHN DEERE HEALTHCARE
P00791748OtherRAILROAD MEDICARE
TN38627331Medicare PIN