Basic Information
| Provider Information | |||||||||
| NPI: | 1124555206 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | UJEVICH | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 CHAMBERS DR | ||||||||
| Address2: | |||||||||
| City: | MONACA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150611349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246308384 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2580 CONSTITUTION BLVD | ||||||||
| Address2: | |||||||||
| City: | BEAVER FALLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150101294 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247736844 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | OT018009 | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | OS020535 | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.