Provider Demographics
NPI:1699732198
Name:ANEY, MATTHEW THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:THOMAS
Last Name:ANEY
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:590 W RIDGE RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-1094
Mailing Address - Country:US
Mailing Address - Phone:276-228-2405
Mailing Address - Fax:276-228-4573
Practice Address - Street 1:590 W RIDGE RD
Practice Address - Street 2:SUITE J
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-1094
Practice Address - Country:US
Practice Address - Phone:276-228-2405
Practice Address - Fax:276-228-4573
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2013-05-19
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Provider Licenses
StateLicense IDTaxonomies
VA0101251748208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF54806Medicare UPIN