Healthcare Provider Details

I. General information

NPI: 1356584213
Provider Name (Legal Business Name): MATTHEW DAVID PIERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2009
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 SCHILLING RD
HUNT VALLEY MD
21031-1134
US

IV. Provider business mailing address

17 SPARKS STATION RD
SPARKS GLENCOE MD
21152-9334
US

V. Phone/Fax

Practice location:
  • Phone: 410-427-3910
  • Fax:
Mailing address:
  • Phone: 919-724-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2013-00030
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number8919706-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036174457
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number2013-00030
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number036174457
License Number StateIL
# 6
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number8919706-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: