Provider Demographics
NPI:1053728956
Name:TRAN, MATTHEW (DPM)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 COULTER AVE
Mailing Address - Street 2:STE 109
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2418
Mailing Address - Country:US
Mailing Address - Phone:610-645-6314
Mailing Address - Fax:610-645-9923
Practice Address - Street 1:140 NUTT RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-3906
Practice Address - Country:US
Practice Address - Phone:215-913-8206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-13
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006598213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist