Individual
SARAH ANNE MATTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(800) 653-6568
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601012142
MI
363AM0700X
Medical Physician Assistant
Primary
5601012142
MI
390200000X
Student in an Organized Health Care Education/Training Program
5601012142
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003699265
—
MI
Enumeration date
08/14/2023
Last updated
04/07/2026
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