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Contact Information

MATTHEW KOPP, MD
593 EDDY ST
CLAVERICK 2
PROVIDENCE, RI02903-4923
 Phone: 401-854-2504
 Fax: 401-854-2519
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for MATTHEW KOPP · (Male)

NPI # 1649284852
Status Active
Credentials MD
Entity Individual
Enumeration date 07/27/2006
Last updated 09/17/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • RI License # MD10366
  • MA Medicaid 0158640
  • RI Medicaid MK37221
  • Other 9300960093 RAILROAD MEDICARE
  • MA Other 12/29/2008 TUFTS HEALTH PLAN
  • RI Other 409011 BLUECHIP
  • RI Other 12/14/2006 NHPRI
  • RI Other 939025129 RI MEDICARE GROUP NUMBER
Hospital affiliation(s)
  • MIRIAM HOSPITAL - (Acute Care)
    164 SUMMIT AVENUE
    PROVIDENCE, RI 02906
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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