Small, Matthew G
Small, Matthew G is an individual health care provider with primary practice located at 965 S Bailey Ave Suite 2-1, South Haven MI 49090-9701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Small, Matthew G can be contacted via phone (269) 639-2772.Contact Information
Primary practice address
965 S Bailey Ave Suite 2-1
South Haven MI 49090-9701
Phone: (269) 639-2772
Fax: (269) 639-2770
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 4301083155 | Michigan |
Profile Details
| NPI number | 1336168871 |
|---|---|
| LBN Legal business name | Small, Matthew G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Nov 30th, 2016 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336168871 | NPPES |
| Michigan | MEDICAID | 4628853 T10 |
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