Individual
DR. KRISTIANNA DOMINIQUE MATTHEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
863 N PINE RD, STE A, ESSEXVILLE, MI 48732-2159
(989) 928-3566
(989) 391-9596
Mailing address
863 N PINE RD, STE A, ESSEXVILLE, MI 48732-2159
(989) 928-3566
(989) 391-9596
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
KM066182
MI
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
4301066182
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0807800522
BCBSM
—
01
—
383569775
SHEAKLEY UNICOMB
—
05
—
4267386
—
MI
01
—
H30738
HAP
—
01
—
P00060645
PALMETTO
—
Enumeration date
11/02/2005
Last updated
04/07/2017
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