Provider Demographics
NPI:1023394475
Name:NEUMANN, MATTHEW LEWIS (ATC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:LEWIS
Last Name:NEUMANN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SANDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:998 HOSPITALITY WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-1762
Practice Address - Country:US
Practice Address - Phone:410-273-9776
Practice Address - Fax:410-273-9777
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00001592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer