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Individual

MATTHEW UPHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, CRNA

Contact information

Practice address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(215) 612-4000
Mailing address
4620 RICHMOND ST, PHILADELPHIA, PA 19137-2215
(215) 779-0220

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN563334
PA

Other

Enumeration date
01/29/2021
Last updated
03/10/2021
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