Potts, Matthew Ray

Potts, Matthew Ray is an individual health care provider with primary practice located at 354 Copperfield Blvd Ne , Concord NC 28025-2402. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Potts, Matthew Ray can be contacted via phone (704) 786-5122.

Contact Information

Primary practice address
354 Copperfield Blvd Ne Concord NC 28025-2402
Phone: (704) 786-5122
Fax: (704) 782-8279
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 0001-04182 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 104182 North Carolina

Profile Details

NPI number 1407839079
LBN Legal business name Potts, Matthew Ray
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2005
Last updated Nov 21st, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407839079 NPPES
Georgia MEDICAID 215715106A
Georgia MEDICAID 215715106B
Georgia MEDICAID 215715106D
Georgia MEDICAID 215715106C
Georgia MEDICAID 215715106E

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