Provider Demographics
NPI:1811375074
Name:DARNELL, MATTHEW (PHD, RD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:DARNELL
Suffix:
Gender:M
Credentials:PHD, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2349
Mailing Address - Country:US
Mailing Address - Phone:440-759-5617
Mailing Address - Fax:
Practice Address - Street 1:3400 S WATER ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2349
Practice Address - Country:US
Practice Address - Phone:440-759-5617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005207133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered