Individual
MATTHEW CHARLES DOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 646-1222
Mailing address
71 HAYNES ST, MANCHESTER, CT 06040-4131
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2816
CT
363AS0400X
Surgical Physician Assistant
2816
CT
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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