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General NPI Number Information
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NPI Number | 1871791772
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Entity Type | Individual
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Provider Name | ANDREA MICHELLE MATTHEWS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 1630 MAIN STREET SUITE #101
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City | CHESTER
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State | MD
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Zip | 21619-9998
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Country | US
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Telephone | 410-604-6560
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Fax | 410-643-5789
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Provider Business Mailing Address
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Address Line | 1630 MAIN STREET SUITE #101
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City | CHESTER
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State | MD
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Zip | 21619-9998
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Country | US
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Telephone | 410-604-6560
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Fax | 410-643-5789
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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 | C1-0009446
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License Number State | DE
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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 | D0077299
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LL29786
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29786
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License Number State | SC
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