Davis, Matthew L

Davis, Matthew L is an individual health care provider with primary practice located at 2500 Niles Road Suite #7, St. Joseph MI 49085. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Davis, Matthew L can be contacted via phone (269) 982-7844.

Contact Information

Primary practice address
2500 Niles Road Suite #7 St. Joseph MI 49085
Phone: (269) 982-7844
Fax: (269) 982-1783
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 4301084762 Michigan

Profile Details

NPI number 1528004744
LBN Legal business name Davis, Matthew L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jan 25th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528004744 NPPES
Michigan Other 4301084762 STATE LISCENSE

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