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Individual

KRISTOPHER MICHAEL MATELIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-2000
Mailing address
4106 MERRICK ST, DEARBORN HEIGHTS, MI 48125-2854
(734) 778-0262

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704270927
MI
367500000X
Certified Registered Nurse Anesthetist
240691
AK
367500000X
Certified Registered Nurse Anesthetist
Primary
4704270927
MI

Other

Enumeration date
04/23/2015
Last updated
07/29/2025
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