Provider Demographics
NPI:1659751642
Name:MARR, MATTHEW JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:MARR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:800 TURNPIKE STREET SUITE 202
Mailing Address - Street 2:JEFFERSON OFFICE PARK
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-557-5712
Mailing Address - Fax:978-557-5406
Practice Address - Street 1:800 TURNPIKE STREET SUITE 202
Practice Address - Street 2:JEFFERSON OFFICE PARK
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-557-5712
Practice Address - Fax:978-557-5406
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT208004208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA274237OtherMA BOARD OF REGISTRATION IN MEDICINE