Matthew Charles Dolan, PA-C
Physician Assistant in Manchester, CT. Individual provider (NPI-1).
NPI number1770834657
StatusActive
Last updated in NPPESOct 2, 2012
Details
- NPI
- 1770834657
- Entity type
- Individual (NPI-1)
- Name
- Matthew Charles Dolan
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 2, 2012
- Last updated
- Oct 2, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 2816 | CT | Yes |
| 363AS0400X | Physician Assistant, Surgical | 2816 | CT |
Practice location
71 Haynes StManchester, CT 06040-4131
Phone 860-646-1222
Mailing address
71 Haynes StManchester, CT 06040-4131
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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