Individual
DR. KEN MATSUO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1253
(203) 709-8820
(203) 709-3679
Mailing address
PO BOX 1090, WINDSOR, CT 06095-6190
(800) 925-7270
(888) 331-1015
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
53316
CT
208M00000X
Hospitalist Physician
53316
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2011
Last updated
08/18/2014
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