Provider Demographics
NPI:1194711820
Name:MATCARE, LLC
Entity type:Organization
Organization Name:MATCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-224-2255
Mailing Address - Street 1:133 DEFENSE HWY
Mailing Address - Street 2:SUITE 111
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7098
Mailing Address - Country:US
Mailing Address - Phone:410-224-2255
Mailing Address - Fax:410-224-0726
Practice Address - Street 1:133 DEFENSE HWY
Practice Address - Street 2:SUITE 111
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7098
Practice Address - Country:US
Practice Address - Phone:410-224-2255
Practice Address - Fax:410-224-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052023207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD956610400Medicaid
MDG5730001OtherFEP BCBS
MDKDNSOtherBCBS
MDG59387Medicare PIN
MD464M695FMedicare PIN
MD464MMedicare PIN