MEDICARE: CHAD JASON MATHEWS PA-C

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	363AM0700X	Medical Physician Assistant	MA050889	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00204849	OTHER	GA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1184621427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD JASON MATHEWS PA-C

Provider Business Mailing Address
First Line	:	2501 SHENANGO VALLEY FWY
Second Line	:	STE 1
City	:	HERMITAGE
State	:	PA
Zip	:	16148-2536
Country	:	US
Telephone Number	:	724-983-1820
Fax Number	:	724-983-1822

Provider Business Practice Location Address
First Line	:	2501 SHENANGO VALLEY FWY
Second Line	:	STE 1
City	:	HERMITAGE
State	:	PA
Zip	:	16148-2536
Country	:	US
Telephone Number	:	724-983-1820
Fax Number	:	724-983-1822

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	07/08/2007

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Directions to “ CHAD JASON MATHEWS PA-C” Practice Location

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