Healthcare Provider Details

I. General information

NPI: 1003073388
Provider Name (Legal Business Name): MATTHEW CRAIG CINDRIC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 JEFFERSON AVE STE 104
SCRANTON PA
18510-1636
US

IV. Provider business mailing address

743 JEFFERSON AVE STE 104
SCRANTON PA
18510-1636
US

V. Phone/Fax

Practice location:
  • Phone: 570-207-0433
  • Fax: 570-770-4406
Mailing address:
  • Phone: 570-207-0433
  • Fax: 570-770-4406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD438710
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD438710
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT 184375
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number31756
License Number StateWV
# 5
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number31756
License Number StateWV

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: