Individual
MATTHEW MCDONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 WORLDS FAIR DR, SOMERSET, NJ 08873-1369
(732) 537-0909
(732) 564-9032
Mailing address
2 WORLDS FAIR DR, SOMERSET, NJ 08873-1369
(732) 537-0909
(732) 564-9032
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25MA09317500
NJ
207XS0117X
Orthopaedic Surgery of the Spine Physician
25MA09317500
NJ
207XX0801X
Orthopaedic Trauma Physician
25MA09317500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2679201
MEDICARE INDIVIDUAL NUMBER
NJ
Enumeration date
06/01/2007
Last updated
06/15/2020
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