Individual
DR. MICHAEL JOHN MATSUURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-6704
Mailing address
8716 POLISHED PEBBLE WAY, LAUREL, MD 20723-5909
(410) 328-6704
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D72797
MD
208D00000X
General Practice Physician
MD-14431
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
442253800
—
MD
Enumeration date
12/12/2008
Last updated
02/24/2012
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