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Organization

MATHEWS MEDICAL CENTER PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAZIN YONAN MD (PRESIDENT)
(248) 250-9497
Entity
Organization

Contact information

Practice address
2221 LIVERNOIS RD, SUITE 100, TROY, MI 48083-1603
(248) 250-9474
(248) 250-9483
Mailing address
2221 LIVERNOIS RD, SUITE 100, TROY, MI 48083-1603
(248) 250-9474
(248) 250-9483

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MY075033
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0F38151
BCBS
MI
01
13069
CAPE HEALTH PLAN
MI
01
136976
CARE CHOICES
MI
01
148498
GREAT LAKES HEALTH PLAN
MA
05
4696174
MI
01
57510
TOTAL HEALTH PLAN
MI
01
H88115
HAP
MI
01
P00296825
RAILROAD MEDICARE
MI
Enumeration date
10/26/2006
Last updated
08/09/2010
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