Doctor Name: | CHARLES CARTER MATTHEWS |
NPI Number: | 1275770646 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DVM |
License Number: | 090.003330 |
Business Practice Address: | 619 Wentworth Ave Calumet City, IL - 604094222 |
Business Phone Number: | 7088621900 |
Business Fax Number: | 7088627321 |
Mailing Address: | 619 Wentworth Ave, CALUMET CITY |
State: | IL |
Postal Code: | 604094222 |
Phone Number: | 7088621900 |
Fax Number: | 7088627321 |
NPI Enumeration Date: | 01/07/2009 |
NPI Last Update Date: | 01/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174M00000X |
License Number: | 090.003330 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Veterinarian |
Taxonomy Specialization: | |
Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |