Healthcare Provider Details

I. General information

NPI: 1851674717
Provider Name (Legal Business Name): MATTHEW SCHWANKE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 BLUE RIDGE RD
RALEIGH NC
27612-8010
US

IV. Provider business mailing address

3237 BLUE RIDGE RD
RALEIGH NC
27612-8010
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-7500
  • Fax:
Mailing address:
  • Phone: 919-781-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number001003132
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001003132
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: