Healthcare Provider Details

I. General information

NPI: 1831551803
Provider Name (Legal Business Name): COLLEEN MATHEWS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2016
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE.
PITTSBURGH PA
15224-1821
US

IV. Provider business mailing address

3600 FORBES AVENUE FORBES TOWER - PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-5055
  • Fax: 412-692-7693
Mailing address:
  • Phone: 502-629-6000
  • Fax: 502-629-4617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number52303
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT220822
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: