Individual
DR. O L MATTHEWS
Active
Individual
DR. O L MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
207R00000X
MI
207RC0000X
Cardiovascular Disease Physician
Primary
4301038649
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000001262
CAPE MEDICAL
MI
01
—
00000001262A
CAPE MEDICAL - INKSTER
MI
01
—
0608226582
BCBS
MI
01
—
0668200330
BCBSM - INKSTER
MI
01
—
068820033
BCBS FEP - INKSTER
MI
01
—
124114
GREAT LAKES HEALTH PLAN
MI
05
—
1805767
—
MI
01
—
382418536
OMNI HEALTH PLAN
MI
01
—
47040
OMINCARE - INKSTER
MI
01
—
505724
CARE CHOICES
MI
01
—
P9074
BLUE CARE NETWORK
MI
Enumeration date
05/02/2006
Last updated
10/20/2020
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