MEDICARE: ALAN KEN MATSUMOTO M.D.

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	207RR0500X	Rheumatology Physician	D0036867	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	103774	OTHER		FIRST HEALTH
2	1847871	OTHER		UNITED HEALTHCARE
3	493058	OTHER		NCPPO
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	21470	OTHER		PRIORITY PARTNERS
6	7169832	OTHER		MAMSI
7	0004482962	OTHER		AETNA
8	397348	OTHER		ALLIANCE
9	0009	OTHER	DC	CAREFIRST OF DC
10	52147007	OTHER	MD	CAREFIRST OF MARYLAND

General Provider Information

NPI Number	:	1043219298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN KEN MATSUMOTO M.D.

Provider Business Mailing Address
First Line	:	2730 UNIVERSITY BLVD W
Second Line	:	SUITE 310
City	:	WHEATON
State	:	MD
Zip	:	20902-1905
Country	:	US
Telephone Number	:	301-942-7600
Fax Number	:	301-942-3132

Provider Business Practice Location Address
First Line	:	2730 UNIVERSITY BLVD W
Second Line	:	SUITE 310
City	:	WHEATON
State	:	MD
Zip	:	20902-1905
Country	:	US
Telephone Number	:	301-942-7600
Fax Number	:	301-942-3132

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	03/11/2021

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Directions to “ ALAN KEN MATSUMOTO M.D.” Practice Location

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