Individual
MATTHEW MINARIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7750 TOWN CENTRE DR STE 300, BROADVIEW HEIGHTS, OH 44147-4040
(877) 283-8863
Mailing address
7750 TOWN CENTRE DR STE 300, BROADVIEW HEIGHTS, OH 44147-4040
(877) 238-8863
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.004059
OH
363A00000X
Physician Assistant
Primary
5601006700
MI
363AM0700X
Medical Physician Assistant
5601006700
MI
363AM0700X
Medical Physician Assistant
MA056138
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112106
—
OH
Enumeration date
11/07/2013
Last updated
11/16/2016
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