MEDICARE: ALEXANDER MATHEW MD

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	208600000X	Surgery Physician	01046182	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043240781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER MATHEW MD

Provider Business Mailing Address
First Line	:	2516 Q ST
Second Line	:
City	:	BEDFORD
State	:	IN
Zip	:	47421-4928
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2516 Q ST
Second Line	:
City	:	BEDFORD
State	:	IN
Zip	:	47421-4928
Country	:	US
Telephone Number	:	812-279-9771
Fax Number	:

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	01/05/2023

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Directions to “ ALEXANDER MATHEW MD” Practice Location

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