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Individual

HOLLY K MATHEWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5000
Mailing address
11800 E 12 MILE RD, WARREN, MI 48093-3472

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005911
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0326PA
SC
Enumeration date
06/16/2006
Last updated
01/27/2011
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