Individual
DR. O L MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
29201 TELEGRAPH RD STE 400, SOUTHFIELD, MI 48034-7647
(248) 949-9888
(248) 325-5998
Mailing address
PO BOX 250581, FRANKLIN, MI 48025-0581
(313) 871-3200
(313) 871-2996
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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