Organization
MD MATT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SHAFFER (OWNER)
(443) 220-6122
Entity
Organization
Contact information
Practice address
309 E PATRICK ST, FREDERICK, MD 21701-6792
(240) 292-1088
Mailing address
10220 S DOLFIELD RD STE 106, OWINGS MILLS, MD 21117-3660
(443) 559-4137
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/18/2020
Last updated
07/16/2024
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