Provider Demographics
NPI:1144226150
Name:STRAKA, MATTHEW BURRILL (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:BURRILL
Last Name:STRAKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 OHIO RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-2056
Mailing Address - Country:US
Mailing Address - Phone:412-741-5670
Mailing Address - Fax:412-741-8520
Practice Address - Street 1:1099 OHIO RIVER BLVD
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-2056
Practice Address - Country:US
Practice Address - Phone:412-741-5670
Practice Address - Fax:412-741-8520
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072266L207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA055608K08Medicare PIN
PAH56048Medicare UPIN