Individual
MATTHEW MICHAEL MCDONELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2205 JOLLY RD, SUITE B, OKEMOS, MI 48864-3983
(517) 347-4085
(517) 347-4170
Mailing address
PO BOX 1239, TROY, MI 48099-1239
(248) 824-6600
(855) 618-6655
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704249339
MI
Other
Enumeration date
09/18/2008
Last updated
07/10/2014
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