Healthcare Provider Details

I. General information

NPI: 1639167984
Provider Name (Legal Business Name): MATTHEW J BEHIL O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 09/19/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4389 BEAUFORT RD
CHERRY POINT NC
28533
US

IV. Provider business mailing address

4389 BEAUFORT RD
CHERRY POINT NC
28533
US

V. Phone/Fax

Practice location:
  • Phone: 252-466-0259
  • Fax:
Mailing address:
  • Phone: 252-466-0921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD00003640
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: