# MD MATT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508636762
- **Authorized official:** WILLIAM SHAFFER (OWNER)
- **Authorized official phone:** (443) 220-6122

## Contact information

- **Practice address:** 265 MILL ST STE 700, HAGERSTOWN, MD 21740-6181
- **Practice address phone:** (443) 559-4137
- **Mailing address:** 625 S CLINTON ST, BALTIMORE, MD 21224-4009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2024
- **Last updated:** 01/08/2024