Individual
DR. MATTHEW CHARLES AXTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2770 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-8614
(616) 267-8860
(616) 267-8442
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
5101019792
MI
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
5101019792
MI
Other
Enumeration date
01/31/2007
Last updated
11/05/2024
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