Provider Demographics
NPI:1982649810
Name:LEPITO, MATTHEW JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:LEPITO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FILA WAY
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152
Mailing Address - Country:US
Mailing Address - Phone:410-472-9625
Mailing Address - Fax:410-472-9627
Practice Address - Street 1:10 FILA WAY
Practice Address - Street 2:SUITE 208
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152
Practice Address - Country:US
Practice Address - Phone:410-472-9625
Practice Address - Fax:410-472-9627
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDV08511Medicare UPIN
MD487GMedicare ID - Type UnspecifiedPROVIDER NUMBER