MEDICARE: DR. MATTHEW WESLEY MEDLEY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	5101020024	MI
2	390200000X	Student in an Organized Health Care Education/Training Program	5101020024	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5101020024	OTHER	MI	OSTEOPATHIC MEDICINE AND SURGERY PHYSICIAN LICENSE
2	5315055607	OTHER	MI	BOARD OF PHARMACY CONTROLLED SUBSTANCE LICENSE

General Provider Information

NPI Number	:	1033473053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW WESLEY MEDLEY DO

Provider Business Mailing Address
First Line	:	5900 BYRON CENTER AVE SW
Second Line	:	ATTN: MEDICAL ADMINISTRATION
City	:	WYOMING
State	:	MI
Zip	:	49519-9606
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7686 GEORGETOWN CENTER DR
Second Line	:
City	:	JENISON
State	:	MI
Zip	:	49428-8101
Country	:	US
Telephone Number	:	616-252-8600
Fax Number	:	616-252-8660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2012
Last Update Date	:	03/07/2023

Similar Medicare Providers

1447255914 — DR. ROBERT C HUIZENGA O D
Practice Location Address:

7673 GEORGETOWN CENTER DR
JENISON, MI
49428-8101

Practice Phone: 616-457-2020
Practice Fax: 616-457-4043

1629046503 — ANITA MARIA VANDERSTELT D.O.
Practice Location Address:

7686 GEORGETOWN CTR DR
JENISON, MI
49428-8101

Practice Phone: 616-252-8600
Practice Fax: 616-252-8660

1235192188 — DIANA L DILLMAN D.O.
Practice Location Address:

7686 GEORGETOWN CENTER DR
JENISON, MI
49428-8101

Practice Phone: 616-252-8600
Practice Fax: 616-252-8660

1154384931 — KARL O BREITWEISER D.O.
Practice Location Address:

7686 GEORGETOWN CENTER DR
JENISON, MI
49428-8101

Practice Phone: 616-252-8600
Practice Fax: 616-252-8660

1922062108 — JAMES B MITTON D.O.
Practice Location Address:

7686 GEORGETOWN CENTER DR
JENISON, MI
49428-8101

Practice Phone: 616-252-4765
Practice Fax: 616-252-0127

1134529993 — MEGAN MOUSER NP-C
Practice Location Address:

7686 GEORGETOWN CENTER DR
JENISON, MI
49428-8101

Practice Phone: 616-252-8600
Practice Fax: 616-252-8660

Directions to “ DR. MATTHEW WESLEY MEDLEY DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.