Healthcare Provider Details

I. General information

NPI: 1588579635
Provider Name (Legal Business Name): MATTHEW AARON NAYLOR CHW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 COMMERCE AVE SW
GRAND RAPIDS MI
49503-4107
US

IV. Provider business mailing address

530 NEW AVENUE SW
GRAND RAPIDS MI
49503
US

V. Phone/Fax

Practice location:
  • Phone: 616-588-8761
  • Fax:
Mailing address:
  • Phone: 616-293-2329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: