Individual
DR. MICHAEL S. MATTIKOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2282 HAMBURG TPKE, SUITE E, WAYNE, NJ 07470-6291
(973) 696-7300
(973) 835-0520
Mailing address
2282 HAMBURG TPKE, SUITE E, WAYNE, NJ 07470-6291
(973) 696-7300
(973) 835-0520
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA02206300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
471804
MEDICARE PROVIDER ID
NJ
Enumeration date
06/28/2006
Last updated
02/03/2015
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