Provider Demographics
NPI:1063888345
Name:MATTHEWS, COREY RAY (DO)
Entity type:Individual
Prefix:DR
First Name:COREY
Middle Name:RAY
Last Name:MATTHEWS
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2525 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4518
Mailing Address - Country:US
Mailing Address - Phone:612-813-6248
Mailing Address - Fax:612-813-6397
Practice Address - Street 1:2525 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4518
Practice Address - Country:US
Practice Address - Phone:612-813-6248
Practice Address - Fax:612-813-6397
Is Sole Proprietor?:No
Enumeration Date:2015-08-20
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00703902085P0229X
KY055142085P0229X
MN699172085P0229X
OK60242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology