Individual
MATTHEW DENENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 W 13 MILE RD STE EC, ROYAL OAK, MI 48073-6712
(248) 898-5058
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(616) 285-0846
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301065906
MI
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
4301065906
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
930129097
RAILROAD MEDICARE
MI
Enumeration date
07/28/2006
Last updated
08/31/2022
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