Individual
RYAN MATTHEW O'GOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7310
(508) 941-6339
Mailing address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 207-7600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001528
CT
363A00000X
Physician Assistant
Primary
1163
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003015286
—
CT
Enumeration date
07/12/2006
Last updated
11/18/2025
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