Provider Demographics
NPI:1679571442
Name:COLE, MATTHEW R (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:COLE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:134 INDUSTRIAL PARK RD STE 1500
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-8153
Mailing Address - Country:US
Mailing Address - Phone:724-689-1822
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:530 SOUTH ST STE G10
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-837-3111
Practice Address - Fax:724-837-3022
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2019-10-04
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Provider Licenses
StateLicense IDTaxonomies
PAOS009992L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018403540001Medicaid
PA0018403540001Medicaid
PAP00262465Medicare PIN
PAH37351Medicare UPIN