Provider Demographics
NPI:1295060093
Name:SCHMALZRIEDT, MATTHEW JACOB (POM)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JACOB
Last Name:SCHMALZRIEDT
Suffix:
Gender:M
Credentials:POM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 46TH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-2943
Mailing Address - Country:US
Mailing Address - Phone:505-550-2227
Mailing Address - Fax:
Practice Address - Street 1:401 SHADY AVE STE B-2051
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4409
Practice Address - Country:US
Practice Address - Phone:412-620-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM981171100000X
PAOM000261171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist