| Doctor Name: | DR. MICHAEL JOHN MATSUURA |
| NPI Number: | 1720223175 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD-14431 |
| Business Practice Address: | 22 S Greene St Baltimore, MD - 212011544 |
| Business Phone Number: | 4103286704 |
| Business Fax Number: | |
| Mailing Address: | 8716 Polished Pebble Way, LAUREL |
| State: | MD |
| Postal Code: | 207235909 |
| Phone Number: | 4103286704 |
| Fax Number: | |
| NPI Enumeration Date: | 12/12/2008 |
| NPI Last Update Date: | 02/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD-14431 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | HI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |