Organization
O L MATTHEWS MD PC
Active
Other names
Annapolis Medical Specialty Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. O L MATTHEWS M.D. (PHYSICIAN)
(248) 949-9888
Entity
Organization
Contact information
Practice address
29201 TELEGRAPH RD STE 400, SOUTHFIELD, MI 48034-7647
(248) 949-9888
(248) 325-5998
Mailing address
29201 TELEGRAPH RD STE 400, SOUTHFIELD, MI 48034-7647
(248) 949-9888
(248) 325-5998
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0608226582
BLUE CROSS BLUE SHIELD OF MI PIN
MI
05
—
1805767
—
MI
Enumeration date
03/04/2009
Last updated
10/20/2020
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