MATCLINIC PHYSICIANS PRACTICE GROUP LLC (NPI# 1760031876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760031876 |
| Entity Type | Organization |
| Organization Name | MATCLINIC PHYSICIANS PRACTICE GROUP LLC |
| Practice Address |
40 S Dundalk Ave Ste 400 Dundalk MD 21222-4273 |
| Mailing Address |
503 Albemarle St Baltimore MD 21202-4304 |
| Practice Telephone | 4102200780 |
| Practice Fax Number | 4108620150 |
| Mailing Telephone | 4102200780 |
| Mailing Fax Number | 4108620150 |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2020-08-07 |
| Authorized Official Name | DANIEL RECK (MANAGER) |
| Authorized Official Telephone | 4102200780 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 265074600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548825813 | Matclinic Physicians Practice Group LLC | Counselor | 40 York Rd Ste 201, Towson, MD 21204-5243 | 2019-05-02 |
| 1356801534 | Matclinic Physicians Practice Group LLC | Internal Medicine | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2019-03-22 |
| 1194217091 | Matclinic Physicians Practice Group LLC | Counselor | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2018-06-06 |
| 1699385336 | Matclinic Physicians Practice Group LLC | Clinic/Center | 40 York Rd Ste 201, Towson, MD 21204-5243 | 2020-08-07 |
| 1417567157 | Matclinic Physicians Practice Group LLC | Clinic/Center | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2020-08-07 |
| 1336759075 | Matclinic Physicians Practice Group LLC | Clinic/Center | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2020-08-07 |
| 1316557051 | Matclinic Physicians Practice Group LLC | Clinic/Center | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2020-08-07 |
| 1841840808 | Matclinic Physicians Practice Group LLC | Community/Behavioral Health | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2019-09-12 |
| 1669022620 | Matclinic Physicians Practice Group LLC | Community/Behavioral Health | 40 York Rd Ste 201, Towson, MD 21204-5243 | 2019-09-12 |
| 1750930863 | Matclinic Physicians Practice Group LLC | Clinic/Center | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2019-09-11 |
| Street Address |
40 S DUNDALK AVE STE 400 |
| City | DUNDALK |
| State | MD |
| Zip Code | 21222-4273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255534756 | Enrique Ivan Oviedo | Psychiatry & Neurology | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2007-06-11 |
| 1336759075 | Matclinic Physicians Practice Group LLC | Clinic/Center | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2020-08-07 |
| 1720637747 | Matclinic Physicians Practice Group LLC | Community/Behavioral Health | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2019-09-11 |
| 1801448360 | Matclinic Physicians Practice Group LLC | Counselor | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2019-07-15 |
| 1063904985 | Matclinic Physicians Practice Group LLC | Clinical Medical Laboratory | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2018-06-06 |
| 1073037479 | Betty Githuku | Nurse Practitioner | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2017-07-28 |
| 1104375294 | Matclinic Physicians Practice Group LLC | Counselor | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222 | 2016-09-29 |
| 1285927723 | Tetyana Evans | Nurse Practitioner | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2011-05-17 |
| 1023307733 | Lorena Blanco | Counselor | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2011-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922634534 | Progressive Multi Medical Services Inc | Nurse Practitioner | 7704 Trappe Road, Dundalk, MD 21222 | 2020-03-14 |
| 1881240802 | Waleed Mazhar Khan | Pharmacist | 29-31 Sipping Pl, Baltimore, MD 21222 | 2019-08-15 |
| 1043773724 | Agnes Kavari | Occupational Therapy Assistant | 7232 German Hill Road, Heritage Center, Baltimore, MD 21222 | 2019-04-10 |
| 1609335702 | Addiction Treatment of Maryland | Substance Abuse Rehabilitation Facility | 19 Center Place, 1st Floor, Baltimore, MD 21222 | 2019-03-18 |
| 1558833368 | Millennium Residential Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1709 Holaview Road, Dundalk, MD 21222 | 2018-12-19 |
| 1639691447 | Tenicia S Washington | Nurse Practitioner | 1709 Holaview Rd, Dundalk, MD 21222 | 2017-07-13 |
| 1548708126 | Kevin Anthony Mason | Counselor | 7827 Wise Avenue, Dundalk Counseling Center, Baltimore, MD 21222 | 2017-02-03 |
| 1023569266 | Rachel Renee Barbarino | Physician Assistant | 1934 Ewald Ave, Baltimore, MD 21222 | 2016-10-24 |
| 1023562576 | Bd Health Services, Inc | Counselor | 3955 North Point Rd., Dundalk, MD 21222 | 2016-08-12 |
| 1205287596 | Dundalk Health Services, Inc. | Counselor | 6706 Holabird Ave, Baltimore, MD 21222 | 2016-06-28 |
| Find all providers in zip 21222 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245898444 | Conversion Health System, LLC | Clinic/Center | 1709 Holaview Rd, Dundalk, MD 21222 | 2019-06-03 |
| 1023505666 | Associated Catholic Charities, Inc. | Clinic/Center | 2 N Dundalk Ave, Dundalk, MD 21222-4221 | 2018-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817075 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 2648 Guilford Ave Apt 1fl, Baltimore, MD 21218-4611 | 2020-10-02 |
| 1851998892 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 2648 Guilford Ave Apt 2fl, Baltimore, MD 21218-4611 | 2020-10-02 |
| 1801403324 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 328 E 26th St, Baltimore, MD 21218-4702 | 2020-09-29 |
| 1275148975 | Hel Recovery Center | Clinic/Center | 1900 N Howard St Fl 2, Baltimore, MD 21218-5909 | 2020-09-10 |
| 1497365654 | Inspiring Change Mental Health Services, LLC. | Clinic/Center | 4654 York Rd Ste 1, Baltimore, MD 21212-4726 | 2020-08-03 |
| 1174132518 | Sabinas House LLC | Clinic/Center | 3103 Mareco Ave, Baltimore, MD 21213-1619 | 2020-07-30 |
| 1134738909 | Sabinas House LLC | Clinic/Center | 2224 Dukeland St, Baltimore, MD 21216-2812 | 2020-07-28 |
| 1881203792 | Sabinas House LLC | Clinic/Center | 3325 Shannon Dr, Baltimore, MD 21213-1823 | 2020-07-27 |
| 1356950265 | Sabinas House LLC | Clinic/Center | 616 Wildwood Pkwy, Baltimore, MD 21229-1810 | 2020-07-27 |
| 1598374407 | Sabinas House LLC | Clinic/Center | 605 Springfield Ave, Baltimore, MD 21212-4832 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MATCLINIC PHYSICIANS PRACTICE GROUP LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.