Provider Demographics
NPI:1821478751
Name:KOPERWAS, MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:KOPERWAS
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 1:5889 FORBES AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-4601
Mailing Address - Country:US
Mailing Address - Phone:412-622-7343
Mailing Address - Fax:412-621-8235
Practice Address - Street 1:5889 FORBES AVE
Practice Address - Street 2:STE 200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-4601
Practice Address - Country:US
Practice Address - Phone:412-622-7343
Practice Address - Fax:412-621-8235
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD465731207QG0300X, 207Q00000X
PAMT208444390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program