MEDICARE: DR. MATTHEW LAVIGNE MCGEE M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	4301046108	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2506327071	OTHER	MI	BCBS OF MICHIGAN

General Provider Information

NPI Number	:	1811982804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW LAVIGNE MCGEE M.D.

Provider Business Mailing Address
First Line	:	1950 E WATTLES RD
Second Line	:	SUITE 110
City	:	TROY
State	:	MI
Zip	:	48085-5099
Country	:	US
Telephone Number	:	248-528-0050
Fax Number	:	248-528-0909

Provider Business Practice Location Address
First Line	:	1950 E WATTLES RD
Second Line	:	SUITE 110
City	:	TROY
State	:	MI
Zip	:	48085-5099
Country	:	US
Telephone Number	:	248-528-0050
Fax Number	:	248-528-0909

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	12/22/2020

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Directions to “ DR. MATTHEW LAVIGNE MCGEE M.D.” Practice Location

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