Matclinic Physicians Practice Group Llc

LBN: Matclinic Physicians Practice Group Llc
Matclinic Physicians Practice Group Llc is an health care organization with primary practice located at 107 Ridgely Ave Ste 12 , Annapolis MD 21401-1417. The organization recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Allopathic & Osteopathic Physicians / Addiction Medicine is the primary health care specialty. Matclinic Physicians Practice Group Llc can be contacted via phone (410) 220-0780, or through Reck, Dan via phone (410) 220-0780.

Contact Information

Primary practice address
107 Ridgely Ave Ste 12 Annapolis MD 21401-1417
Phone: (410) 220-0780
Fax: (410) 862-0150
Website:
Map and Directions
Authorized official contact:
Name: Reck, Dan
Phone: (410) 220-0780

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1356801534
LBN Legal business name Matclinic Physicians Practice Group Llc
DBA Doing business as
Authorized official Reck, Dan
Entity Organization
Organization subpart 1 No
Enumeration date Mar 22nd, 2019
Last updated May 11th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356801534 NPPES
Maryland MEDICAID 135675502

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