Individual
DR. ADNAN H MATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4090 E 14 MILE RD STE 100, WARREN, MI 48092-1196
(586) 858-4111
(586) 858-4641
Mailing address
4090 E14 MILE RD STE 100, WARREN, MI 48092-1196
(586) 858-4111
(586) 858-4641
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
AM034389
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0206353551
BCBS
MI
05
—
101701996
—
MI
01
—
382296393
COMMERCIAL
MI
Enumeration date
05/17/2006
Last updated
01/16/2025
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