Provider Demographics
NPI:1932195856
Name:BURGER, MATTHEW DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DAVID
Last Name:BURGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 HAYMAKER RD
Mailing Address - Street 2:SUITE #401
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3518
Mailing Address - Country:US
Mailing Address - Phone:412-372-6330
Mailing Address - Fax:412-372-4291
Practice Address - Street 1:2580 HAYMAKER RD
Practice Address - Street 2:SUITE #401
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3518
Practice Address - Country:US
Practice Address - Phone:412-372-6330
Practice Address - Fax:412-372-4291
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052137L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA251219366OtherGROUP TAX ID
PAP16844Medicare UPIN
PA093623EE0Medicare PIN