MEDICARE: DR. MATTHEW F SOULIER MD

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	2084P0800X	Psychiatry Physician	224157	MA
2	2084F0202X	Forensic Psychiatry Physician	A105316	CA

General Provider Information

NPI Number	:	1417935255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW F SOULIER MD

Provider Business Mailing Address
First Line	:	1050 IRON POINT RD
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-8013
Country	:	US
Telephone Number	:	916-597-2340
Fax Number	:	916-597-2341

Provider Business Practice Location Address
First Line	:	1050 IRON POINT RD
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-8013
Country	:	US
Telephone Number	:	916-597-2340
Fax Number	:	916-597-2341

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

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	07/21/2022

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