| Matclinic Physicians Practice Group Llc | |
|
40 York Rd Ste 201 Towson MD 21204-5243 | |
| (410) 220-0780 | |
| (410) 862-0150 |
| Full Name | Matclinic Physicians Practice Group Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 40 York Rd Ste 201, Towson, 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 40 York Rd Ste 201 Towson MD 21204-5243 Ph: (410) 220-0780 |
| NPI Number | 1699385336 |
|---|---|
| Provider Enumeration Date | 08/07/2020 |
| Last Update Date | 05/11/2022 |
| Certification Date | 05/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699385336 | NPI | - | NPPES |
| 661011103 | Medicaid | MD | |
| 200710013 | Other | MD | DEPT OF HEALTH, BEHAVIORAL HEALTH ADMIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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