Provider Demographics
NPI:1861509325
Name:CORRIERE, MATTHEW ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ABRAHAM
Last Name:CORRIERE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-8536
Mailing Address - Fax:614-293-8902
Practice Address - Street 1:1800 ZOLLINGER RD FL 2
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2800
Practice Address - Country:US
Practice Address - Phone:614-293-8536
Practice Address - Fax:614-293-8902
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2024-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301109248208600000X, 2086S0129X, 208600000X
OH35.1504182086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5909106Medicaid
NCNC6726AMedicare PIN