Individual
MR. DAISUKE MATSUO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2480 LLEWELLYN AVE, FORT MEADE, MD 20755-7081
(301) 677-8694
Mailing address
USAMEDDAC 2480 LLEWELLYN AVE, FORT MEADE, MD 20755-4031
(301) 677-8694
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R191414
MD
Other
Enumeration date
06/22/2018
Last updated
11/27/2024
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