Basic Information
| Provider Information | |||||||||
| NPI: | 1285098004 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EMERY | ||||||||
| FirstName: | MATTHEW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1572 AUSTIN DR | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432203104 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1405 S. HIGH ST. | ||||||||
| Address2: | OSU/NCH INTERNAL MEDICINE-PEDIATRIC RESIDENCY PROG. | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143559000 | ||||||||
| FaxNumber: | 6143559010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2016 | ||||||||
| LastUpdateDate: | 05/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35133614 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 35133614 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | 208M00000X | 35133614 | OH | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.