Provider Demographics
NPI:1053675405
Name:SNIEZEK, MATTHEW PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:PAUL
Last Name:SNIEZEK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HILLCREST DR
Mailing Address - Street 2:APT 4
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-2947
Mailing Address - Country:US
Mailing Address - Phone:724-971-6529
Mailing Address - Fax:
Practice Address - Street 1:79 WAGNER RD
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-2337
Practice Address - Country:US
Practice Address - Phone:724-773-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-30
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT014781207R00000X
PAOS017507207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty