Provider Demographics
NPI:1104830579
Name:VOSS, MATTHEW R (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:VOSS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3407 WILKENS AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5072
Mailing Address - Country:US
Mailing Address - Phone:410-644-5111
Mailing Address - Fax:410-644-2715
Practice Address - Street 1:3407 WILKENS AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5072
Practice Address - Country:US
Practice Address - Phone:410-644-5111
Practice Address - Fax:410-644-2715
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2018-04-27
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Provider Licenses
StateLicense IDTaxonomies
MDD0066765207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
I01179Medicare UPIN