Individual
MATTHEW JAMES DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 GARLAND ST, EVERETT, MA 02149-5066
(617) 389-6270
Mailing address
47 WINFORD WAY, WINCHESTER, MA 01890-4030
(781) 570-6067
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA8320
BOARD OF REGISTRATION OF PHYSICIAN ASSISTANTS
MA
Enumeration date
05/04/2021
Last updated
11/15/2021
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