Individual
BRIAN RICHARD MATLAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-7739
Mailing address
PO BOX 64255, BALTIMORE, MD 21264-4255
(410) 550-7008
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
D64132
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410696200
—
MD
Enumeration date
05/13/2006
Last updated
02/12/2013
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