| Matthew Raider Md Llc | |
|
645 Saybrook Rd Middletown CT 06457-4746 | |
| (860) 767-4024 | |
| Not Available |
| Full Name | Matthew Raider Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 645 Saybrook Rd, Middletown, Connecticut |
| Authorized Official Name and Position | Matthew J Raider (SOLE PROPRIETOR) |
| Authorized Official Contact | 8607674024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Raider Md Llc 645 Saybrook Rd Middletown CT 06457-4746 Ph: (860) 767-4024 | Matthew Raider Md Llc 645 Saybrook Rd Middletown CT 06457-4746 Ph: (860) 767-4024 |
| NPI Number | 1093952194 |
|---|---|
| Provider Enumeration Date | 01/11/2009 |
| Last Update Date | 02/19/2009 |
| Medicare PECOS PAC ID | 1254495245 |
|---|---|
| Medicare Enrollment ID | O20090206000145 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093952194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 22948 (Connecticut) | Primary |
| Provider Name | Matthew J Raider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073562674 PECOS PAC ID: 4587677737 Enrollment ID: I20060711000224 |
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