MEDICARE: DR. MATTHEW ISAACS 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	207Q00000X	Family Medicine Physician	2024-00579	NC

General Provider Information

NPI Number	:	1104406230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW ISAACS M.D.

Provider Business Mailing Address
First Line	:	2100 STANTONSBURG RD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-2818
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 CREEDMOOR RD STE 208
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-1711
Country	:	US
Telephone Number	:	919-327-1650
Fax Number	:

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

Provider Enumeration Date	:	04/13/2021
Last Update Date	:	06/17/2026

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