Active NPI
Marco Paolo Miral Matlock
- Pharmacist
- Hagerstown, MD
National Provider Identifier
1962362251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 30665
- Practice address
- 1631 Dual Hwy
Hagerstown, MD 21740-6545 - Phone
- (301) 305-9032
- NPI assigned
- Nov 18, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 30665 | MD | Primary |
Addresses
Primary practice location
1631 Dual Hwy
Hagerstown, MD 21740-6545
Mailing address
40042 Branca Dr
Frederick, MD 21702-8203
Phone (301) 305-9032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30665 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763424000000",
"number": "1962362251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40042 BRANCA DR",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217028203",
"telephone_number": "301-305-9032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 DUAL HWY",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217406545",
"telephone_number": "301-305-9032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLOCK",
"first_name": "MARCO PAOLO",
"middle_name": "MIRAL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-18",
"last_updated": "2025-11-18",
"certification_date": "2025-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "30665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.