Provider Demographics
NPI:1154804623
Name:COFFIN, MATTHEW CHARLES (PA-C)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:CHARLES
Last Name:COFFIN
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3448 S HAWK DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-6016
Mailing Address - Country:US
Mailing Address - Phone:801-850-8490
Mailing Address - Fax:
Practice Address - Street 1:10 AVIEMORE DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9700
Practice Address - Country:US
Practice Address - Phone:910-715-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant