Wallen, Matthew C

Wallen, Matthew C is an individual health care provider with primary practice located at 401 North Live Oak Drive , Moncks Corner SC 29461. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Wallen, Matthew C can be contacted via phone (843) 761-8721.

Contact Information

Primary practice address
401 North Live Oak Drive Moncks Corner SC 29461
Phone: (843) 761-8721
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 023720 South Carolina

Profile Details

NPI number 1962442921
LBN Legal business name Wallen, Matthew C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Apr 21st, 2009 - about 15 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 1962442921 NPPES
South Carolina MEDICAID 237201

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