Healthcare Provider Details

I. General information

NPI: 1992202956
Provider Name (Legal Business Name): MATTHEW JOSEPH MICHEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 LAKEHURST RD STE 101
TOMS RIVER NJ
08755-8063
US

IV. Provider business mailing address

530 LAKEHURST RD STE 101
TOMS RIVER NJ
08755-8063
US

V. Phone/Fax

Practice location:
  • Phone: 732-349-8454
  • Fax: 732-341-0259
Mailing address:
  • Phone: 732-349-8454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA186021
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA186021
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA12890000
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number25MA12890000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: