Individual
MATTHEW ALLEN TRIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
905 E COLBY ST, WHITEHALL, MI 49461
(231) 728-5910
(231) 728-5918
Mailing address
PO BOX 1848, MUSKEGON, MI 49443-1848
(231) 727-5211
(231) 727-4571
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002724
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MI7481013
MEDICARE PTAN
MI
Enumeration date
06/04/2006
Last updated
06/06/2018
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