Provider Demographics
NPI:1699747162
Name:MATTHEWS, MAUREEN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:MARIE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAUREEN
Other - Middle Name:MARIE
Other - Last Name:MAHAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7087 WEST BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4335
Mailing Address - Country:US
Mailing Address - Phone:330-758-8183
Mailing Address - Fax:330-758-8849
Practice Address - Street 1:7087 WEST BLVD STE 3
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4335
Practice Address - Country:US
Practice Address - Phone:330-758-8183
Practice Address - Fax:330-758-8849
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-64221207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0994652Medicaid
OHF43936Medicare UPIN
OH0728832Medicare PIN