Organization
COMMUNITY CARE PLUS
Active
Organization
COMMUNITY CARE PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW J COPPOLA M.D. (OWNER)
(412) 367-3121
Entity
Organization
Contact information
Practice address
601 MONROE AVE, PITTSBURGH, PA 15202-3520
(412) 920-5860
(412) 920-5861
Mailing address
PO BOX 16008, PITTSBURGH, PA 15242-0008
(412) 920-5860
(412) 920-5861
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016005720007
—
PA
01
—
888998
BLUESHIELD
PA
Enumeration date
04/11/2006
Last updated
02/20/2008
Update your record
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