# MATRIX HOUSE PHYSICIANS PA

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

## Provider details

- **NPI number:** 1780631556
- **Authorized official:** MR. NADEHZDA KOVALCHUK M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (301) 552-8118

## Contact information

- **Practice address:** 8118 GOOD LUCK RD, LANHAM, MD 20706-3595
- **Practice address phone:** (301) 552-8118
- **Practice address fax:** (301) 498-3074
- **Mailing address:** PO BOX 17301, BALTIMORE, MD 21297-1301
- **Mailing address phone:** (301) 498-2922
- **Mailing address fax:** (301) 498-3074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 11/14/2011