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Organization

MATCLINIC PHYSICIANS PRACTICE GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAN RECK (MANAGER)
(410) 220-0780
Entity
Organization

Contact information

Practice address
40 S DUNDALK AVE STE 400, DUNDALK, MD 21222-4273
(410) 220-0780
(410) 862-0150
Mailing address
PO BOX 9068, BALTIMORE, MD 21222-0768
(410) 220-0720
(410) 862-0150

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200710011
DEPT OF HEALTH, BEHAVIORAL HEALTH ADMIN
MD
05
661011102
MD
Enumeration date
08/07/2020
Last updated
05/11/2022
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