Individual
MICHAEL MATTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-4101
Mailing address
6896 W SNOWVILLE RD, BRECKSVILLE, OH 44141-3214
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35-07-6913
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000271444
ANTHEM
OH
01
—
000000372956
ANTHEM
OH
05
—
2196967
—
OH
01
—
341960760039
CARESOURCE
OH
05
—
4429911
—
MI
01
—
727147
BCHP
OH
05
—
810547599034
—
OH
Enumeration date
04/10/2006
Last updated
12/24/2007
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