MEDICARE: DR. CHARLES MATTHEWS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	0027245	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C7117	OTHER	NC	MEDCOST
2	0555719	OTHER	NC	UNITED HEALTH CARE
3	54818	OTHER	NC	BCBS OF NC
4	1435715	OTHER	NC	CIGNA
5	4403914	OTHER	NC	AETNA
6	P80705	OTHER	NC	GREAT WEST

General Provider Information

NPI Number	:	1891866885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES MATTHEWS M.D.

Provider Business Mailing Address
First Line	:	904 VANCE ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27608-2348
Country	:	US
Telephone Number	:	919-649-6806
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 ATRIUM DR
Second Line	:	SUITE 400
City	:	RALEIGH
State	:	NC
Zip	:	27607-6452
Country	:	US
Telephone Number	:	919-781-7423
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. CHARLES MATTHEWS M.D.” Practice Location

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