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Individual
STACEY MATTHEWS
Active
Individual
STACEY MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
SM010543
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G80003
BCBS OF MICHIGAN
MI
01
—
6400072
PHP
MI
01
—
990503
HEALTHPLUS
MI
01
—
P26307F
BLUE CARE NETWORK MI
MI
Enumeration date
08/09/2005
Last updated
12/13/2025
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