Individual
MATTHEW COPONEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
15 PARK CREEK DR, GREENVILLE, SC 29605-4270
(864) 271-7761
(864) 235-2045
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28419
SC
363LP2300X
Primary Care Nurse Practitioner
28419
SC
Other
Enumeration date
02/21/2024
Last updated
02/26/2024
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