Petrie, Matthew Shane

Petrie, Matthew Shane is an individual health care provider with primary practice located at 3055 Washington Rd Suite 203, Mc Murray PA 15317-3279. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Petrie, Matthew Shane can be contacted via phone (724) 260-5424.

Contact Information

Primary practice address
3055 Washington Rd Suite 203 Mc Murray PA 15317-3279
Phone: (724) 260-5424
Fax: (724) 260-5425
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X D72126 Maryland
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X MD438908 Pennsylvania
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD438908 Pennsylvania
Allopathic & Osteopathic Physicians / Dermatology 207N00000X D72126 Maryland

Profile Details

NPI number 1114128808
LBN Legal business name Petrie, Matthew Shane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2007
Last updated Jan 9th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114128808 NPPES
Pennsylvania MEDICAID 102851711-0002

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