MEDICARE: ISHA MATTHEWS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1023460409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISHA MATTHEWS

Provider Business Mailing Address
First Line	:	3212 REED ST APT 2724
Second Line	:
City	:	GLENARDEN
State	:	MD
Zip	:	20706-1553
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3212 REED ST APT 2724
Second Line	:
City	:	GLENARDEN
State	:	MD
Zip	:	20706-1553
Country	:	US
Telephone Number	:	240-883-1561
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2016
Last Update Date	:	07/08/2016

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Directions to “ ISHA MATTHEWS ” Practice Location

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