DR. MATTHEW DIRK WILLARD DC NPI 1619124286

NPI Information

NPI: 1619124286
Provider Name: DR. MATTHEW DIRK WILLARD, DC
Classification: Chiropractor - 111N00000X
Entity Type: Individual
Address:
141 VINEGAR HILL ROAD
WINSTON SALEM, NC
ZIP 27104
Phone: (336) 448-1894
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DR. Matthew Dirk Willard, DC is a chiropractor in Winston Salem, NC. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. DR. Matthew Dirk Willard, DC NPI is 1619124286. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

141 VINEGAR HILL ROAD
WINSTON SALEM, NC
ZIP 27104
Phone: (336) 448-1894
Fax: (336) 448-1895

The enumeration date for this NPI number is 8/26/2008 and was last updated on 1/30/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		3904	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5950449	MEDICAID	NORTH CAROLINA
2	111N00000X	OTHER		TAXONOMY
3	2456085	OTHER	NORTH CAROLINA	MEDICARE PTAN
4	086CJ	OTHER	NORTH CAROLINA	BLUE CROSS PTAN
5	2451497B	OTHER	NORTH CAROLINA	MEDICARE GROUP PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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