MEDICARE: WARREN BRUCE MATTHEWS 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	MD020995E	PA

General Provider Information

NPI Number	:	1689623233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WARREN BRUCE MATTHEWS M.D.

Provider Business Mailing Address
First Line	:	8250 OLD YORK RD # 2
Second Line	:
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-1514
Country	:	US
Telephone Number	:	215-886-0440
Fax Number	:	215-886-0477

Provider Business Practice Location Address
First Line	:	8250 OLD YORK RD # 2
Second Line	:
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-1514
Country	:	US
Telephone Number	:	215-886-0440
Fax Number	:	215-886-0477

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/21/2022

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