Individual
DR. MATTHEW RYAN COUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-6400
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OT024096
PA
2083A0100X
Aerospace Medicine Physician
0102206795
VA
208D00000X
General Practice Physician
0102206795
VA
Other
Enumeration date
01/04/2020
Last updated
05/13/2025
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