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1427053362

NPI Code Detail

MEDICARE: PAUL DAVID MATZKIN MD

MEDICARE: PAUL DAVID MATZKIN 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	207Q00000X	Family Medicine Physician	11853	NH
2	208M00000X	Hospitalist Physician	11853	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01YP05069NH02	OTHER	NH	ANTHEM
2	714677	OTHER	NH	MVP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4677414	OTHER	NH	CIGNA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427053362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL DAVID MATZKIN MD

Provider Business Mailing Address
First Line	:	250 PLEASANT ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-7539
Country	:	US
Telephone Number	:	603-227-7000
Fax Number	:	603-227-7191

Provider Business Practice Location Address
First Line	:	250 PLEASANT ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-7539
Country	:	US
Telephone Number	:	603-227-7000
Fax Number	:	603-227-7191

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	04/10/2017

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Directions to “ PAUL DAVID MATZKIN MD” Practice Location

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