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General NPI Number Information
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NPI Number | 1013501055
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Entity Type | Individual
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Provider Name | WILLIAM MATTHEWS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/20/2021
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Last Update Date | 02/20/2021
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Provider Practice Location Address
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Address Line | 9805 ROCKY RIVER RD
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City | CHARLOTTE
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State | NC
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Zip | 28215-8922
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Country | US
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Telephone | 704-918-0267
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Fax |
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Provider Business Mailing Address
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Address Line | 1112 THOROUGHBRED PL NW
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City | CONCORD
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State | NC
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Zip | 28027-8683
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Country | US
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Telephone | 704-918-0267
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 30045
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License Number State | NC
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