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NPI Code Detail

MEDICARE: ANNE S MATOVSKI PA-C

MEDICARE: ANNE S MATOVSKI PA-C
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
1363A00000XPhysician Assistant5601006603MI

General Provider Information

NPI Number : 1083953129
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE S MATOVSKI PA-C
Provider Business Mailing Address
First Line : 43740 GARFIELD RD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-1122
Country : US
Telephone Number : 586-228-0270
Fax Number : 586-228-9019
Provider Business Practice Location Address
First Line : 28098 23 MILE RD
Second Line :
City : CHESTERFIELD
State : MI
Zip : 48051-2316
Country : US
Telephone Number : 586-949-0123
Fax Number : 586-228-9019
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2013
Last Update Date : 12/07/2018

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Directions to “ ANNE S MATOVSKI PA-C” Practice Location

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