Healthcare Provider Details

I. General information

NPI: 1992992705
Provider Name (Legal Business Name): MATTHEW CARL SARDELLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 HEALTH PARK BLVD
GRAND BLANC MI
48439-7383
US

IV. Provider business mailing address

6400 WALDON CENTER DR
CLARKSTON MI
48346-4808
US

V. Phone/Fax

Practice location:
  • Phone: 810-953-0500
  • Fax: 810-953-0031
Mailing address:
  • Phone: 810-953-0500
  • Fax: 810-953-0031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number4301084379
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301084379
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: