Organization
MD MATT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SHAFFER (DIRECTOR)
(443) 559-4137
Entity
Organization
Contact information
Practice address
12 CRAIN HWY N, GLEN BURNIE, MD 21061-3565
(410) 575-1255
Mailing address
225 S CASTLE ST, BALTIMORE, MD 21231-2602
(443) 220-6122
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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