Provider Demographics
NPI:1467205518
Name:MACKIN, MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:MACKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5662 ROBERTS STREET
Mailing Address - Street 2:APT 118
Mailing Address - City:HALIFAX
Mailing Address - State:NS
Mailing Address - Zip Code:B3K 0E3
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5662 ROBERTS STREET
Practice Address - Street 2:APT 118
Practice Address - City:HALIFAX
Practice Address - State:NS
Practice Address - Zip Code:B3K 0E3
Practice Address - Country:CA
Practice Address - Phone:902-213-3545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ018216207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology