Provider Demographics
NPI:1104616382
Name:MATTHEWS, MARIE A
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:A
Last Name:MATTHEWS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 BLACK HAWK DR
Mailing Address - Street 2:
Mailing Address - City:FOREST HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1207
Mailing Address - Country:US
Mailing Address - Phone:240-601-4600
Mailing Address - Fax:
Practice Address - Street 1:1315 STAPLES ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3925
Practice Address - Country:US
Practice Address - Phone:202-840-3472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant