Provider Demographics
NPI:1396164372
Name:MATTHEWS, MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8218 WISCONSIN AVE STE P14
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3138
Mailing Address - Country:US
Mailing Address - Phone:301-656-6055
Mailing Address - Fax:301-656-6058
Practice Address - Street 1:8218 WISCONSIN AVE STE P14
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3138
Practice Address - Country:US
Practice Address - Phone:301-656-6055
Practice Address - Fax:301-656-6058
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1646213E00000X, 213ES0131X
VA103301247213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist