Matlock, Jamie Elizabeth

Matlock, Jamie Elizabeth is an sole proprietor health care provider with primary practice located at 1413 Madison Park Dr Fl 2 , Glen Burnie MD 21061-5613. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Matlock, Jamie Elizabeth can be contacted via phone (410) 691-3571.

Contact Information

Primary practice address
1413 Madison Park Dr Fl 2 Glen Burnie MD 21061-5613
Phone: (410) 691-3571
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X C06695 Maryland

Profile Details

NPI number 1578080719
LBN Legal business name Matlock, Jamie Elizabeth
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 28th, 2017
Last updated Apr 25th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578080719 NPPES
Maryland MEDICAID 777033200

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