Individual
MATTHEW P KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
28501 ORCHARD LAKE RD, 120, FARMINGTON HILLS, MI 48334-2951
(248) 553-9800
(248) 553-9808
Mailing address
7225 OLD OAK BLVD, #B303, MIDDLEBURG HEIGHTS, OH 44130
(440) 243-7400
(440) 243-9034
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
049666
OH
207W00000X
Ophthalmology Physician
Primary
4301102751
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000512381
ANTHEM
OH
01
—
0931159
BCBSM
MI
05
—
1821093535
—
MI
Enumeration date
06/17/2005
Last updated
10/02/2013
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