Individual
DR. MATTHEW DAVID SOWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
12 LENHART RD, FLEETWOOD, PA 19522-8613
(610) 944-6537
(610) 944-8152
Mailing address
12 LENHART RD, PO BOX 425, FLEETWOOD, PA 19522-8613
(610) 944-6537
(610) 944-8152
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC-004634-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001634338
—
PA
01
—
1627980
HIGHMARK BLUE SHIELD
PA
01
—
50058771
CAPITAL BLUE CROSS
PA
Enumeration date
10/02/2005
Last updated
12/11/2012
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