Healthcare Provider Details

I. General information

NPI: 1023418316
Provider Name (Legal Business Name): MATTHEW STEVEN HINSHAW PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 09/11/2020
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N 16TH ST
NEW CASTLE IN
47362-4319
US

IV. Provider business mailing address

9849 N ANCHOR BND
MCCORDSVILLE IN
46055-5511
US

V. Phone/Fax

Practice location:
  • Phone: 765-521-0890
  • Fax:
Mailing address:
  • Phone: 765-524-2048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number10001714A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: