Individual
DR. MATTHEW AUGUST TIEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9686
(616) 252-7159
Mailing address
PO BOX 186, GRAND RAPIDS, MI 49501-0186
(616) 364-6700
(616) 364-4960
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301081884
MI
2085R0204X
Vascular & Interventional Radiology Physician
4301081884
MI
Other
Enumeration date
04/17/2007
Last updated
02/05/2019
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