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Individual

DR. MATOUS PRADNY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 985-4632
Mailing address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 985-4632

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01066616A
IN
207R00000X
Internal Medicine Physician
4301088348
MI
207R00000X
Internal Medicine Physician
Primary
EMC0006119
MI
390200000X
Student in an Organized Health Care Education/Training Program
4301088348
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000626995
BCBS
IN
Enumeration date
06/11/2007
Last updated
01/24/2025
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