MEDICARE: DR. KAMERON LEIGH MATTHEWS MD, JD

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	036124675	IL
2	207Q00000X	Family Medicine Physician	MD045568	DC

General Provider Information

NPI Number	:	1902028822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAMERON LEIGH MATTHEWS MD, JD

Provider Business Mailing Address
First Line	:	495 FLATBUSH AVE STE C5
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-3706
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	546 EASTERN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-1604
Country	:	US
Telephone Number	:	--
Fax Number	:

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	05/15/2023

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