Provider Demographics
NPI:1578305520
Name:DOYLE, MATTHEW RYAN (MED)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:RYAN
Last Name:DOYLE
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1146
Mailing Address - Country:US
Mailing Address - Phone:803-587-8292
Mailing Address - Fax:
Practice Address - Street 1:504 MEADOWBROOK LN
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-3729
Practice Address - Country:US
Practice Address - Phone:803-587-8292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8892101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional