Individual
MATTHEW ROBERT GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5352 BECKLEY RD, BATTLE CREEK, MI 49015-4155
(269) 965-4500
(269) 965-1150
Mailing address
300 NORTH AVE, CBO-, BATTLE CREEK, MI 49017-0000
(269) 245-8230
(269) 245-8251
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006130
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104840529
BCBS - BRONSON
MI
05
—
1336475219
—
MI
Enumeration date
10/27/2009
Last updated
11/27/2023
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