Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD431388 | PA |
NPI | 1144278458 |
---|---|
Provider Name | Dr. Matthew M. Puc |
First Address | Fountain Hill, PA 18015-1155 |
Second Address | Fountain Hill, PA 18015-1155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 19/10/2020 |