Matusovich, Charles S

Matusovich, Charles S is an individual health care provider with primary practice located at 2 Chabot St , Westbrook ME 04092-4817. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Matusovich, Charles S can be contacted via phone (207) 857-9311.

Contact Information

Primary practice address
2 Chabot St Westbrook ME 04092-4817
Phone: (207) 857-9311
Fax: (207) 857-9324
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R042849 Maine

Profile Details

NPI number 1134143514
LBN Legal business name Matusovich, Charles S
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Oct 21st, 2015 - about 11 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 1134143514 NPPES
Maine MEDICAID 287750099

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