| Doctor Name: | MR. MATTHEW LEONARD CADWALLADER |
| NPI Number: | 1457364705 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | MA002594L |
| Business Practice Address: | 1401 Bethlehem Pike Flourtown, PA - 190311904 |
| Business Phone Number: | 2152331001 |
| Business Fax Number: | 2152339749 |
| Mailing Address: | 424 W Price St, PHILADELPHIA |
| State: | PA |
| Postal Code: | 191444406 |
| Phone Number: | 2157139595 |
| Fax Number: | |
| NPI Enumeration Date: | 08/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA002594L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |