Provider Demographics
NPI:1972529725
Name:COOMBS, MATTHEW BRITT (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:BRITT
Last Name:COOMBS
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 1:3950 BRODHEAD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-3030
Mailing Address - Country:US
Mailing Address - Phone:724-775-5833
Mailing Address - Fax:724-775-7780
Practice Address - Street 1:3950 BRODHEAD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-3030
Practice Address - Country:US
Practice Address - Phone:724-775-5833
Practice Address - Fax:724-775-7780
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422491207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019639900001Medicaid
PA071685LCKMedicare PIN
H89933Medicare UPIN