Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | SC006598 | PA |
N | 222Z00000X | Podiatrist | SC006598 | PA |
Y | 213ES0103X | Foot & Ankle Surgery | SC006598 | PA |
NPI | 1053728956 |
---|---|
Provider Name | Dr. Matthew Tran |
First Address | Ardmore, PA 19003-2418 |
Second Address | Phoenixville, PA 19460-3906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2014 |
Last Update Date | 24/10/2019 |