Individual
MARINA MATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
17108 MACK AVE STE 108, GROSSE POINTE FARMS, MI 48230-6224
(313) 723-2572
Mailing address
17108 MACK AVE STE 108, GROSSE POINTE FARMS, MI 48230-6224
(313) 723-2572
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
02/17/2026
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