Individual
DR. MATTHEW MICHAEL GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W THOMAS RD STE 600, PHOENIX, AZ 85013-4221
(602) 406-4433
(602) 512-6545
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R10852
IA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
60565
AZ
Other
Enumeration date
06/05/2017
Last updated
08/19/2021
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