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General NPI Number Information
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NPI Number | 1558304972
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Entity Type | Individual
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Provider Name | MATTHEW JOHN KING M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 2310 CHRISTOPHER COLUMBUS BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19148-4206
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Country | US
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Telephone | 267-288-0389
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Fax | 267-288-0389
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Provider Business Mailing Address
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Address Line | PO BOX 746722
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City | ATLANTA
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State | GA
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Zip | 30374-6722
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Country | US
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Telephone | 312-733-9730
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Fax | 773-866-8014
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0064388
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD427802
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License Number State | PA
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