Provider Demographics
NPI:1558592618
Name:MAXWELL, MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:MAXWELL
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 1:1010 DELAFIELD RD
Mailing Address - Street 2:MAIL CODE 111 PA, BLDG 51, 1B153
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238
Mailing Address - Country:US
Mailing Address - Phone:412-822-3135
Mailing Address - Fax:
Practice Address - Street 1:1010 DELAFIELD RD
Practice Address - Street 2:MAIL CODE 111 PA, BLDG 51, 1B153
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238
Practice Address - Country:US
Practice Address - Phone:412-822-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012583442081S0010X
DCMD0434512081S0010X
PAMD4442162081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine