Individual
MATTHEW H EVENHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1991 CROCKER RD STE 500, WESTLAKE, OH 44145-1962
(844) 764-4633
(310) 861-0855
Mailing address
304 RUTH ST, BAY VILLAGE, OH 44140-1228
(614) 902-0771
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35082452
OH
208D00000X
General Practice Physician
35082452
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2420893
—
OH
Enumeration date
08/20/2006
Last updated
07/21/2022
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