Provider Demographics
NPI:1730622671
Name:CARON, MATTHEW LUKE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:LUKE
Last Name:CARON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8910
Mailing Address - Country:US
Mailing Address - Phone:207-883-2115
Mailing Address - Fax:
Practice Address - Street 1:233 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-8910
Practice Address - Country:US
Practice Address - Phone:207-883-2115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-27
Last Update Date:2016-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR45992183500000X
NY062304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist