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NPI Code Detail

MEDICARE: EVAN MATTHEW KING

MEDICARE: EVAN MATTHEW KING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantA6130MD
2225200000XPhysical Therapy AssistantA8240NC

General Provider Information

NPI Number : 1568349736
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVAN MATTHEW KING
Provider Business Mailing Address
First Line : 6201 GREENLEIGH AVE
Second Line :
City : MIDDLE RIVER
State : MD
Zip : 21220-2004
Country : US
Telephone Number : 410-933-0000
Fax Number : 410-500-4266
Provider Business Practice Location Address
First Line : 10803 FALLS RD
Second Line :
City : LUTHERVILLE
State : MD
Zip : 21093-4518
Country : US
Telephone Number : 443-997-2663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2025
Last Update Date : 09/29/2025

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Directions to “ EVAN MATTHEW KING ” Practice Location

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