Healthcare Provider Details

I. General information

NPI: 1275533234
Provider Name (Legal Business Name): JOHN F MATTHEWS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N CLAYTON ST
WILMINGTON DE
19805-3165
US

IV. Provider business mailing address

701 N CLAYTON ST
WILMINGTON DE
19805-3165
US

V. Phone/Fax

Practice location:
  • Phone: 302-888-2303
  • Fax:
Mailing address:
  • Phone: 302-888-2303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number25MA07124600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number25MA07124600
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD048348L
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA07124600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: