Provider Demographics
NPI:1215970777
Name:MATTHEWS, MICHELLE ALLYSON (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ALLYSON
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:509 N ELAM AVE
Mailing Address - Street 2:SUITE 3E
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1129
Mailing Address - Country:US
Mailing Address - Phone:336-832-1970
Mailing Address - Fax:336-832-1988
Practice Address - Street 1:2645 MERIDIAN PKWY STE 323
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4232
Practice Address - Country:US
Practice Address - Phone:984-227-8902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401537207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH98142Medicare UPIN