Fagan, Matthew J
Fagan, Matthew J is an individual health care provider with primary practice located at 4375 Ogletown Stanton Road Suite 1208, Newark DE 19713-2089. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is his primary health care specialty. Fagan, Matthew J can be contacted via phone (302) 623-4055.Contact Information
Primary practice address
4375 Ogletown Stanton Road Suite 1208
Newark DE 19713-2089
Phone: (302) 623-4055
Fax: (302) 623-4056
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery | 207VF0040X | MD429235 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | MD429235 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | C10011078 | Delaware |
| Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery | 2088F0040X | C1-0011078 | Delaware |
| Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery | 2088F0040X | MD429235 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery | 207VF0040X | C10011078 | Delaware |
Profile Details
| NPI number | 1538184791 |
|---|---|
| LBN Legal business name | Fagan, Matthew J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | May 30th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538184791 | NPPES |
| Pennsylvania | MEDICAID | 1016687780001 |
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