Healthcare Provider Details

I. General information

NPI: 1043265051
Provider Name (Legal Business Name): MATTHEW PLYMYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PERIMETER PARK DR STE C
MORRISVILLE NC
27560-9714
US

IV. Provider business mailing address

PO BOX 14045
RALEIGH NC
27620-4045
US

V. Phone/Fax

Practice location:
  • Phone: 919-589-2520
  • Fax: 984-239-2619
Mailing address:
  • Phone: 919-350-8277
  • Fax: 919-350-2818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number9300782
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: