Basic Information
| Provider Information | |||||||||
| NPI: | 1699935957 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATTHEWS | ||||||||
| FirstName: | ANDREW | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1648 HUNTINGDON PIKE | ||||||||
| Address2: | MEDICAL STAFF OFFICE 1ST FLR | ||||||||
| City: | MEADOWBROOK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190468001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159383450 | ||||||||
| FaxNumber: | 2159383829 | ||||||||
| Practice Location | |||||||||
| Address1: | 23 BUSTLETON PIKE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | FEASTERVILLE TREVOSE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190536446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154649599 | ||||||||
| FaxNumber: | 2154647865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2008 | ||||||||
| LastUpdateDate: | 07/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD443107 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 102613881 | 05 | PA | MEDICAID | 0266663 | 05 | NJ | MEDICAID |