Provider Demographics
NPI:1760647812
Name:ABAR, MATTHEW (PA)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:ABAR
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1413
Mailing Address - Street 2:
Mailing Address - City:WELLFLEET
Mailing Address - State:MA
Mailing Address - Zip Code:02667
Mailing Address - Country:US
Mailing Address - Phone:508-240-0208
Mailing Address - Fax:508-240-0499
Practice Address - Street 1:49 HARRY KEMP WAY
Practice Address - Street 2:
Practice Address - City:PROVINCETOWN
Practice Address - State:MA
Practice Address - Zip Code:02657
Practice Address - Country:US
Practice Address - Phone:508-487-9395
Practice Address - Fax:508-487-3285
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA00340363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAP0825OtherMEDICARE B
MAS54379Medicare UPIN