Deller, Matthew

Deller, Matthew is an individual health care provider with primary practice located at 33155 Annapolis St , Wayne MI 48184-2405. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Deller, Matthew can be contacted via phone (734) 467-4042.

Contact Information

Primary practice address
33155 Annapolis St Wayne MI 48184-2405
Phone: (734) 467-4042
Fax: (734) 467-5500
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601003936 Michigan

Profile Details

NPI number 1760460257
LBN Legal business name Deller, Matthew
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Oct 22nd, 2007 - about 18 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 1760460257 NPPES
Other 11712508 CAQH

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