Individual
MATTHEW P RICCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
5601003589
MI
363AS0400X
Surgical Physician Assistant
Primary
5601003589
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00284546
RR MEDICARE
—
Enumeration date
10/04/2005
Last updated
09/18/2013
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