Provider Demographics
NPI:1700827292
Name:MATSINGER, JOHN MARK (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MARK
Last Name:MATSINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 120
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:2225 E EVESHAM RD STE 101
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1557
Practice Address - Country:US
Practice Address - Phone:856-795-4330
Practice Address - Fax:856-325-3704
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB07571200208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0006319Medicaid
NJ139103R63Medicare PIN
NJ0006319Medicaid
NJ071147BVPMedicare ID - Type Unspecified
NJ071147YBAWMedicare PIN