Individual
CHRISTOPHER MARTIN MATKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, MAIN BLDG., ROOM 038, PROVIDENCE, RI 02903-4923
(401) 444-4779
(401) 444-7464
Mailing address
593 EDDY ST, POTTER 3, PROVIDENCE, RI 02903-4923
(401) 444-4318
(401) 444-6573
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
MD12658
RI
2084P0800X
Psychiatry Physician
Primary
MD12658
RI
2084P0804X
Child & Adolescent Psychiatry Physician
MD12658
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD12658
RI STATE LICENSE
RI
Enumeration date
05/29/2008
Last updated
02/06/2013
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