MEDICARE: JAMES MATTHEWS

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	35.144653	OH

General Provider Information

NPI Number	:	1629697867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES MATTHEWS

Provider Business Mailing Address
First Line	:	13390 W SPRAGUE RD
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-7140
Country	:	US
Telephone Number	:	440-539-1224
Fax Number	:

Provider Business Practice Location Address
First Line	:	960 CLAGUE RD STE 1100B
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-1590
Country	:	US
Telephone Number	:	440-397-4300
Fax Number	:

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

Provider Enumeration Date	:	04/08/2020
Last Update Date	:	08/01/2023

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Directions to “ JAMES MATTHEWS ” Practice Location

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