| Matclinic Physicians Practice Group Llc | |
|
107 Ridgely Ave Ste 12 Annapolis MD 21401-1417 | |
| (410) 220-0780 | |
| (410) 862-0150 |
| Full Name | Matclinic Physicians Practice Group Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 107 Ridgely Ave Ste 12, Annapolis, Maryland |
| Authorized Official Name and Position | Dan Reck (MANAGER) |
| Authorized Official Contact | 4102200780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matclinic Physicians Practice Group Llc Po Box 9068 Baltimore MD 21222-0768 Ph: (410) 220-0720 | Matclinic Physicians Practice Group Llc 107 Ridgely Ave Ste 12 Annapolis MD 21401-1417 Ph: (410) 220-0780 |
| NPI Number | 1174175632 |
|---|---|
| Provider Enumeration Date | 07/15/2019 |
| Last Update Date | 05/11/2022 |
| Certification Date | 05/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174175632 | NPI | - | NPPES |
| 561008702 | Medicaid | MD |
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