Provider Demographics
NPI:1609847508
Name:PINTO, MATTHEW J (PAC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:J
Last Name:PINTO
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Gender:M
Credentials:PAC
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Mailing Address - Street 1:1 PINCKNEY BLVD
Mailing Address - Street 2:POST OFFICE BOX 6216A ATTN PROFESSIONAL AFFAIRS COORD
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6122
Mailing Address - Country:US
Mailing Address - Phone:843-228-5577
Mailing Address - Fax:843-228-5196
Practice Address - Street 1:2005 KNIGHT LANE BLDG H
Practice Address - Street 2:NAYY MEDICINE SUPPORT COMMAND ATTN MED STAFF SERVICES
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32212-0140
Practice Address - Country:US
Practice Address - Phone:904-542-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2010-02-04
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Provider Licenses
StateLicense IDTaxonomies
FLPA9102391363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000OTHMedicare UPIN