Organization
MACOMB GENERAL AND VASCULAR SURGERY, P.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNN LOUISE MATHIA D.O. (PRESIDENT)
(586) 421-4204
Entity
Organization
Contact information
Practice address
37399 GARFIELD RD, STE. 204, CLINTON TOWNSHIP, MI 48036-3672
(586) 421-4204
Mailing address
37399 GARFIELD RD, STE. 204, CLINTON TOWNSHIP, MI 48036-3672
(586) 421-4204
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101011684
MI
Other
Enumeration date
05/22/2008
Last updated
04/29/2014
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