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Individual
MATTHEW J CONCANNON
Active
Individual
MATTHEW J CONCANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MDR7H73
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1304006
UNITED HEALCARE
MO
01
—
289606
HEALTHLINK
MO
01
—
31925
BLUE CHOICE
MO
Enumeration date
05/20/2006
Last updated
07/08/2007
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