Healthcare Provider Details

I. General information

NPI: 1427053362
Provider Name (Legal Business Name): PAUL DAVID MATZKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT ST
CONCORD NH
03301-7539
US

IV. Provider business mailing address

250 PLEASANT ST
CONCORD NH
03301-7539
US

V. Phone/Fax

Practice location:
  • Phone: 603-227-7000
  • Fax: 603-227-7191
Mailing address:
  • Phone: 603-227-7000
  • Fax: 603-227-7191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11853
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number11853
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: