Organization
MD MATT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SHAFFER (DIRECTOR/OWNER)
(443) 559-4137
Entity
Organization
Contact information
Practice address
10220 S DOLFIELD RD STE 106, OWINGS MILLS, MD 21117-3660
(410) 575-1255
Mailing address
625 S CLINTON ST, BALTIMORE, MD 21224-4009
(443) 559-4137
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/23/2020
Last updated
04/04/2023
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