Individual
MATTHEW J. BIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-7000
Mailing address
30 PARK ST APT 2, BROOKLINE, MA 02446-6257
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
250317
MA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
250317
MA
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
250317
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110093064A
—
MA
Enumeration date
06/09/2009
Last updated
09/13/2023
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