Healthcare Provider Details

I. General information

NPI: 1598224354
Provider Name (Legal Business Name): MICHAEL GERMAIN MATT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVENUE MLC 4010
CINCINNATI OH
45229-3039
US

IV. Provider business mailing address

3333 BURNET AVE ML 4010
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-3316
  • Fax: 513-636-5568
Mailing address:
  • Phone: 513-636-4676
  • Fax: 513-636-5568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number35.144698
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: