Individual
MR. MATTHEW JOHN SICKMILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
269 PORTLAND WAY S, GALION, OH 44833-2312
(419) 468-4841
Mailing address
3117 PLYMOUTH SPRINGMILL RD, SHELBY, OH 44875-9579
(419) 342-3117
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA08723
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2656817
—
OH
Enumeration date
10/11/2006
Last updated
06/20/2019
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