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Individual

DR. MATTHEW E MIDCAP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1020 BLUESTONE DR, LITITZ, PA 17543-7632
(717) 569-9636
Mailing address
1020 BLUESTONE DR, LITITZ, PA 17543-7632

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD045904L
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD045904L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001193153
PA
01
14731
LICENSE NO.
WV
01
18235
ABA CERTIFICATE NO.
01
18436
LICENSE NO.
SC
Enumeration date
09/22/2006
Last updated
09/17/2024
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