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General NPI Number Information
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NPI Number | 1932166683
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Entity Type | Organization
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Legal Business Name | MATTHEWS PLASTIC SURGERY ASSOC PA
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 1450 MATTHEWS TOWNSHIP PKWY SUTIE 270
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City | MATTHEWS
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State | NC
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Zip | 28105-2387
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Country | US
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Telephone | 704-845-9800
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Fax | 704-845-9890
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Provider Business Mailing Address
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Address Line | 1450 MATTHEWS TOWNSHIP PKWY SUITE 270
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City | MATTHEWS
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State | NC
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Zip | 28105-2387
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Country | US
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Telephone | 704-845-9800
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Fax | 704-845-9890
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM J BICKET
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Credential | MD
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Telephone | 704-845-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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