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NPI Code Detail

MEDICARE: MR. MATTHEW J CARLSON PA-C

MEDICARE:  MR. MATTHEW J CARLSON  PA-C
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
12255A2300XAthletic TrainerMA
2363AS0400XSurgical Physician Assistant1037NH
3363AS0400XSurgical Physician AssistantPA5055MA

General Provider Information

NPI Number : 1992028583
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW J CARLSON PA-C
Provider Business Mailing Address
First Line : 575 TURNPIKE ST
Second Line : SUITE 11
City : NORTH ANDOVER
State : MA
Zip : 01845-5924
Country : US
Telephone Number : 978-794-1946
Fax Number : 978-975-3925
Provider Business Practice Location Address
First Line : 323 LOWELL ST
Second Line :
City : ANDOVER
State : MA
Zip : 01810-4659
Country : US
Telephone Number : 978-794-1946
Fax Number : 978-975-3925
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2010
Last Update Date : 12/21/2023

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Directions to “ MR. MATTHEW J CARLSON PA-C” Practice Location

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