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Individual

MATTHEW C SOPHY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
73 COAL ST, PORT CARBON, PA 17965-1823
(570) 622-6302
(570) 622-7153
Mailing address
73 COAL ST, PORT CARBON, PA 17965-1823
(570) 622-6302
(570) 622-7153

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
OS005079L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009455300002
PA
Enumeration date
02/12/2006
Last updated
07/08/2007
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