Provider Demographics
NPI:1710142716
Name:SPARKS, GARRETT MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:MATTHEW
Last Name:SPARKS
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 1:3811 OHARA ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2561
Mailing Address - Country:US
Mailing Address - Phone:412-683-7103
Mailing Address - Fax:
Practice Address - Street 1:3811 OHARA ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2593
Practice Address - Country:US
Practice Address - Phone:412-586-9331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-19
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4428252084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry