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Individual

LEONARD MATTANO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 JOHN ST, STE E-300, KALAMAZOO, MI 49007-5341
(269) 341-6350
Mailing address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282

Taxonomy

Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
4301405921
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3803901681
BCBS
05
4184102
MI
Enumeration date
03/17/2006
Last updated
07/08/2007
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