Basic Information
Provider Information
NPI: 1164982856
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAJOR
FirstName: MATTHEW
MiddleName: BRIAN
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 4420 LAKE BOONE TRL
Address2:  
City: RALEIGH
State: NC
PostalCode: 27607
CountryCode: US
TelephoneNumber: 9197843100
FaxNumber:  
Practice Location
Address1: 3000 NEW BERN AVE
Address2:  
City: RALEIGH
State: NC
PostalCode: 276101231
CountryCode: US
TelephoneNumber: 9193508000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/20/2019
LastUpdateDate: 11/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 11/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
367500000X6998NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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