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MATCLINIC PHYSICIANS PRACTICE GROUP LLC NPI 1598335671


NPI Information

NPI: 1598335671
Provider Name: MATCLINIC PHYSICIANS PRACTICE GROUP LLC
Classification: Internal Medicine - 207RA0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 21D2231420

Address:
1101 OPAL CT STE 301
HAGERSTOWN, MD
ZIP 21740
Phone: (410) 220-0720
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MATCLINIC PHYSICIANS PRACTICE GROUP LLC is an addiction medicine internal medicine in Hagerstown, MD. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. MATCLINIC PHYSICIANS PRACTICE GROUP LLC NPI is 1598335671. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1101 OPAL CT STE 301
HAGERSTOWN, MD
ZIP 21740-947
Phone: (410) 220-0720
Fax: (410) 862-0150

The provider's authorized official is Dan Reck .
The authorized official title is Manager and has the following contact phone number (410) 220-0720.

The CLIA number assigned to this NPI record is 21D2231420 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2021 and was last updated on 5/11/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental HealthNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
3101YP2500XCounselorProfessionalNo
42084A0401XPsychiatry & NeurologyAddiction MedicineNo
52084P0800XPsychiatry & NeurologyPsychiatryNo
6101YA0400XCounselorAddiction (Substance Use Disorder)No
7207RA0401XInternal MedicineAddiction MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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