Individual
MATTHEW RAY TOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
700 GEIPE RD, SUITE 260, BALTIMORE, MD 21228-4147
(410) 747-6655
(410) 744-0378
Mailing address
14 REBECCA LN, OWINGS MILLS, MD 21117-8005
(410) 486-1148
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
01279
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
76899701
BLUE SHIELD
MD
01
—
76899702
BLUE SHIELD
MD
01
—
76899703
BLUE SHIELD
MD
01
—
76899704
BLUE SHIELD
MD
Enumeration date
08/14/2006
Last updated
11/30/2007
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