Provider Demographics
NPI:1437172939
Name:REYNOLDS, MATTHEW R (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:R
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:LAHEY CLINIC
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8000
Mailing Address - Fax:781-744-5261
Practice Address - Street 1:41 MALL RD
Practice Address - Street 2:LAHEY CLINIC
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8000
Practice Address - Fax:781-744-5261
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2019-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA158187207RC0000X, 207RC0001X
NH16134207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110094176AMedicaid
MAA3457701Medicare PIN