Healthcare Provider Details

I. General information

NPI: 1841605086
Provider Name (Legal Business Name): MATTHEW MORIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 UNSER BLVD SE STE 8100
RIO RANCHO NM
87124-3392
US

IV. Provider business mailing address

2400 UNSER BLVD SE STE 8100
RIO RANCHO NM
87124-3392
US

V. Phone/Fax

Practice location:
  • Phone: 505-253-6100
  • Fax:
Mailing address:
  • Phone: 505-253-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD2022-0103
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: