Johnson, Matthew L
Johnson, Matthew L is an sole proprietor health care provider with primary practice located at 251 Woodford St , Portland ME 04103-5617. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Johnson, Matthew L can be contacted via phone (207) 773-2828.Contact Information
Primary practice address
251 Woodford St
Portland ME 04103-5617
Phone: (207) 773-2828
Fax: (207) 761-8150
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | ME012756 | Maine |
Profile Details
| NPI number | 1427114537 |
|---|---|
| LBN Legal business name | Johnson, Matthew L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 1st, 2007 |
| Last updated | Jul 23rd, 2018 - 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 | 1427114537 | NPPES |
| Maine | Other | 040224 | ANTHEM |
| Maine | Other | 108913 | ANTHEM |
| Maine | Other | 100504700 | ANTHEM |
| Maine | MEDICAID | 228090000 | ANTHEM |
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