Provider Demographics
NPI:1326344342
Name:CHARVAT, MATTHEW ROBERT (AT,C)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:ROBERT
Last Name:CHARVAT
Suffix:
Gender:M
Credentials:AT,C
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Mailing Address - Street 1:106 FORESTS EDGE PL
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-1803
Mailing Address - Country:US
Mailing Address - Phone:301-928-2019
Mailing Address - Fax:301-314-6549
Practice Address - Street 1:GOSSETT FOOTBALL TEAM HOUSE
Practice Address - Street 2:379 FIELD HOUSE DRIVE
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20742-0001
Practice Address - Country:US
Practice Address - Phone:301-314-9901
Practice Address - Fax:301-314-6549
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer