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Individual

DR. MATTHEW THOMAS SANTA BARBARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2181
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
4301500305
MI
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
4301500305
MI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/25/2014
Last updated
06/30/2023
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