Provider Demographics
NPI:1225262868
Name:KIRKBRIDE, MATTHEW MASAJI (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:MASAJI
Last Name:KIRKBRIDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12510 PROSPERITY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1663
Mailing Address - Country:US
Mailing Address - Phone:240-485-5210
Mailing Address - Fax:
Practice Address - Street 1:4831 TESLA DR
Practice Address - Street 2:SUITE F
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4323
Practice Address - Country:US
Practice Address - Phone:240-737-0080
Practice Address - Fax:301-464-2783
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0077809207ZP0102X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology