Provider Demographics
NPI:1417396375
Name:RIVER BEND FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:RIVER BEND FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-678-7007
Mailing Address - Street 1:131 N PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21750-1135
Mailing Address - Country:US
Mailing Address - Phone:301-678-7007
Mailing Address - Fax:301-678-7009
Practice Address - Street 1:131 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MD
Practice Address - Zip Code:21750-1135
Practice Address - Country:US
Practice Address - Phone:301-678-7007
Practice Address - Fax:301-678-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056048207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty