MEDICARE: DR. MATTHEW PLYMYER M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	9300782	NC

General Provider Information

NPI Number	:	1043265051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW PLYMYER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 14045
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27620-4045
Country	:	US
Telephone Number	:	919-350-8277
Fax Number	:	919-350-2818

Provider Business Practice Location Address
First Line	:	200 PERIMETER PARK DR STE C
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-9714
Country	:	US
Telephone Number	:	919-589-2520
Fax Number	:	984-239-2619

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	08/05/2022

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