Mataverde, Philip Alexander

Mataverde, Philip Alexander is an individual health care provider with primary practice located at 3200 W Centre Ave Ste 203 , Portage MI 49024-4889. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Sleep Medicine is his primary health care specialty. Mataverde, Philip Alexander can be contacted via phone (269) 349-9745.

Contact Information

Primary practice address
3200 W Centre Ave Ste 203 Portage MI 49024-4889
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X L1865858 Michigan
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 2012020702 Missouri
Allopathic & Osteopathic Physicians / Sleep Medicine 2084S0012X 2012020702 Missouri
Allopathic & Osteopathic Physicians / Sleep Medicine 207RS0012X 5101017269 Michigan

Profile Details

NPI number 1992996458
LBN Legal business name Mataverde, Philip Alexander
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2007
Last updated Nov 27th, 2023 - about 2 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 1992996458 NPPES
Missouri Other P01092598 RAILROAD MEDICARE PTAN
Missouri MEDICAID 1992996458 RAILROAD MEDICARE PTAN

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