Organization
MD MATT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SHAFFER (OWNER OPERATOR)
(443) 220-6122
Entity
Organization
Contact information
Practice address
518 S CAMP MEADE RD STE 5, LINTHICUM, MD 21090-2766
(443) 559-4137
Mailing address
625 S CLINTON ST, BALTIMORE, MD 21224-4009
(443) 559-4137
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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