MEDICARE: MR. MATTHEW JASON RATZ M.ED.

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
1	251C00000X	Developmentally Disabled Services Day Training Agency	15-3470	MD

General Provider Information

NPI Number	:	1780092221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW JASON RATZ M.ED.

Provider Business Mailing Address
First Line	:	16 OWENS GLEN CT
Second Line	:
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-2368
Country	:	US
Telephone Number	:	301-646-6951
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 OWENS GLEN CT
Second Line	:
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-2368
Country	:	US
Telephone Number	:	301-646-6951
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2014
Last Update Date	:	07/29/2014

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