Individual
JULIE A MATYASIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
463 E CIRCLE DR, EAST LANSING, MI 48824
(517) 884-6546
(516) 432-9460
Mailing address
463 E CIRCLE DR, EAST LANSING, MI 48824
(517) 884-6546
(516) 432-9460
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002675
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437203130
—
MI
Enumeration date
01/22/2007
Last updated
11/05/2013
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