Individual
STEPHEN J MATTICHAK
Active
Individual
STEPHEN J MATTICHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35.132423
OH
207RC0000X
Cardiovascular Disease Physician
Primary
4301079048
MI
207RC0000X
Cardiovascular Disease Physician
DR.0059344
CO
207RI0011X
Interventional Cardiology Physician
35.132423
OH
207RI0011X
Interventional Cardiology Physician
DR.0059344
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0258031
—
OH
05
—
4839590
—
MI
05
—
500778985
—
OR
Enumeration date
07/26/2006
Last updated
04/04/2023
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