Provider Demographics
NPI:1902888126
Name:POPPE, MATTHEW M (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:M
Last Name:POPPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1950 CIRCLE OF HOPE DR RM 1570
Mailing Address - Street 2:DEPT. RADIATION ONCOLOGY
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84112-5500
Mailing Address - Country:US
Mailing Address - Phone:801-581-8793
Mailing Address - Fax:
Practice Address - Street 1:1950 CIRCLE OF HOPE DR RM 1570
Practice Address - Street 2:DEPT. RADIATION ONCOLOGY
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-5500
Practice Address - Country:US
Practice Address - Phone:801-581-8793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5161207Q00000X
NJ25MA081947002085R0001X
UT7692036-12052085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine