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General NPI Number Information
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NPI Number | 1295975233
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Entity Type | Organization
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Legal Business Name | O L MATTHEWS MD PC
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Dates
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Enumeration Date | 03/04/2009
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 29201 TELEGRAPH RD STE 400
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City | SOUTHFIELD
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State | MI
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Zip | 48034-7647
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Country | US
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Telephone | 248-949-9888
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Fax | 248-325-5998
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Provider Business Mailing Address
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Address Line | 29201 TELEGRAPH RD STE 400
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City | SOUTHFIELD
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State | MI
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Zip | 48034-7647
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Country | US
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Telephone | 248-949-9888
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Fax | 248-325-5998
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. O L MATTHEWS
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Credential | M.D.
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Telephone | 248-949-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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