Provider Demographics
NPI:1912360462
Name:ORDON, MATTHEW P (MD)
Entity type:Individual
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First Name:MATTHEW
Middle Name:P
Last Name:ORDON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:617-414-5405
Mailing Address - Fax:617-414-6031
Practice Address - Street 1:725 ALBANY STREET, SUITE 7C
Practice Address - Street 2:SHAPIRO BLDG
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-8992
Practice Address - Fax:617-638-8979
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2024-08-23
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Provider Licenses
StateLicense IDTaxonomies
IL125068506207T00000X
CAA185550207T00000X
MA1020694207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery