Basic Information
| Provider Information | |||||||||
| NPI: | 1154906170 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALCUTT | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | AARON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2311 OAKVIEW DR | ||||||||
| Address2: | |||||||||
| City: | NEW BERN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285628585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528768471 | ||||||||
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| Practice Location | |||||||||
| Address1: | 960 NEWMAN RD | ||||||||
| Address2: | |||||||||
| City: | NEW BERN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285625200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2526336730 | ||||||||
| FaxNumber: | 2526336740 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2021 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 5014196 | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.