MEDICARE: DR. MATTHEW C TUFTS 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	208600000X	Surgery Physician	ME140088	FL

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	:	1306284245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW C TUFTS M.D.

Provider Business Mailing Address
First Line	:	4245 KINGS HWY UNIT A
Second Line	:	GENERAL SURGERY
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33980-8416
Country	:	US
Telephone Number	:	941-391-5102
Fax Number	:	941-391-6937

Provider Business Practice Location Address
First Line	:	4245 KINGS HWY UNIT A
Second Line	:	GENERAL SURGERY
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33980-8416
Country	:	US
Telephone Number	:	941-391-5102
Fax Number	:

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

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	06/10/2021

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