Individual
MR. PRASANTH KURIEN MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1685 BALDWIN AVE STE 100, PONTIAC, MI 48340-1115
(248) 706-3450
Mailing address
21080 STRAWBERRY HILLS DR, MACOMB, MI 48044-2274
(586) 262-7873
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704338192
MI
Other
Enumeration date
11/17/2017
Last updated
03/21/2018
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