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General NPI Number Information
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NPI Number | 1659448801
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Entity Type | Individual
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Provider Name | MARTIN HUGH MATTHEWS MD
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 850 W BARAGA AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-4550
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Country | US
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Telephone | 906-449-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 420 W MAGNETIC ST
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City | MARQUETTE
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State | MI
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Zip | 49855-2711
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Country | US
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Telephone | 906-228-9440
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 4301049454
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License Number State | MI
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