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Provider Information for 1851382436

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. BENJAMIN DAN MATTHEWS MD

Gender: MALE

Individual NPI: 1851382436

Calendar   Last Updated:  2008-12-22
  Certification Date: 

Details

Name Value
NPI 1851382436
Enumeration Date 2005-11-02
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-355-6000 | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-355-6000 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other TUFTS HEALTH PLAN MA 160273
Other BCBS MA MA J21813
MEDICAID MA 3203999
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2080P0203X - Pediatrics Pediatric Critical Care Medicine MA 160273
No 208000000X - Pediatrics MA 160273