MEDICARE: MATTHEW BOYD

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	183500000X	Pharmacist	03438227	OH

General Provider Information

NPI Number	:	1003404047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW BOYD

Provider Business Mailing Address
First Line	:	3527 SECOR RD APT 325
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-1523
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5815 SECOR RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-1421
Country	:	US
Telephone Number	:	419-472-8615
Fax Number	:

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

Provider Enumeration Date	:	01/05/2021
Last Update Date	:	01/05/2021

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