Healthcare Provider Details

I. General information

NPI: 1952766412
Provider Name (Legal Business Name): MATTHEW FRENCH UPSON PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2015
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0002
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-8662
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2200
  • Fax: 216-636-5956
Mailing address:
  • Phone: 216-444-2200
  • Fax: 216-636-5956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.009884RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: