Provider Demographics
NPI:1588750103
Name:MATTHEWS-BETTS, CYNTHIA L (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:L
Last Name:MATTHEWS-BETTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 FARROW RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-7001
Mailing Address - Country:US
Mailing Address - Phone:803-933-0288
Mailing Address - Fax:803-933-9920
Practice Address - Street 1:3025 FARROW RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-7001
Practice Address - Country:US
Practice Address - Phone:803-933-0288
Practice Address - Fax:803-933-9920
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F05847Medicare UPIN
7779Medicare PIN