Provider Demographics
NPI:1912983750
Name:MATOS, NELSON J (DO)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:J
Last Name:MATOS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:49 PLAISTOW RD
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2854
Practice Address - Country:US
Practice Address - Phone:603-371-3229
Practice Address - Fax:603-371-3239
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2023-11-16
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Provider Licenses
StateLicense IDTaxonomies
MA160661207P00000X, 207Q00000X
NH23434207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAH13576Medicare UPIN