Individual
MARIE ELIZABETH MATEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
500 KIRTS BLVD STE 200, TROY, MI 48084
(248) 824-6060
(248) 686-0772
Mailing address
788 RANDALL DR, TROY, MI 48085-4854
(917) 373-1886
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
222940
NY
207Q00000X
Family Medicine Physician
Primary
4301082659
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02351068
—
NY
Enumeration date
04/25/2006
Last updated
10/14/2021
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