Healthcare Provider Details

I. General information

NPI: 1063359107
Provider Name (Legal Business Name): MAKAYLA RENEE MATTHEWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4226
US

IV. Provider business mailing address

170 MANNING DR
CHAPEL HILL NC
27514-4221
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-6484
  • Fax:
Mailing address:
  • Phone: 984-974-6484
  • Fax: 919-966-7941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number337270
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: