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:
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Health care specialties

SpecialtyCodeLicense #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 6 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 1427114537 NPPES
Maine Other 040224 ANTHEM
Maine Other 108913 ANTHEM
Maine Other 100504700 ANTHEM
Maine MEDICAID 228090000 ANTHEM

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