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General NPI Number Information
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NPI Number | 1558936237
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Entity Type | Individual
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Provider Name | MATTHEW CHARLES HOGAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 45 WELLS ST # 2020
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City | WESTERLY
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State | RI
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Zip | 02891-2961
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Country | US
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Telephone | 401-596-2020
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Fax | 401-596-6896
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Provider Business Mailing Address
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Address Line | 45 WELLS ST STE 2020
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City | WESTERLY
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State | RI
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Zip | 02891-2961
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Country | US
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Telephone | 401-596-2020
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Fax | 401-444-3056
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | LP05353
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD20282
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License Number State | RI
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