Individual
ANN E MATHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
7751 BYRON CENTER AVE SW, SUITE A, BYRON CENTER, MI 49315-8001
(616) 878-3321
(616) 878-0858
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101012832
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255394185
—
MI
Enumeration date
04/11/2006
Last updated
10/15/2012
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