Individual
MICHAEL MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
607 W MAIN ST, GRANGEVILLE, ID 83530-1345
(208) 983-1700
(208) 983-4665
Mailing address
607 W MAIN ST, GRANGEVILLE, ID 83530-1345
(208) 983-1700
(208) 983-4665
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M14145
ID
Other
Enumeration date
05/29/2015
Last updated
09/30/2020
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