Provider Demographics
NPI:1982126827
Name:MARTIN, MATTHEW GUY (DPM)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:GUY
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 E NORTH AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4740
Mailing Address - Country:US
Mailing Address - Phone:412-359-8079
Mailing Address - Fax:412-359-8070
Practice Address - Street 1:490 E NORTH AVE STE 405
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4740
Practice Address - Country:US
Practice Address - Phone:412-359-8079
Practice Address - Fax:412-359-8070
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASCOO6872213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery