Individual
MATTHEW PHILLIP MEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
560 W MITCHELL ST, PETOSKEY, MI 49770-2275
(231) 487-5400
Mailing address
560 W MITCHELL ST, PETOSKEY, MI 49770-2275
(231) 487-5400
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
4301500934
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301500934
MEDICAL LICENSE
MI
01
—
5315239311
CONTROLLED SUBSTANCE
MI
Enumeration date
06/17/2016
Last updated
10/11/2023
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