Individual
MATT CIESIELSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3300 W CENTRE AVE, BRONSON FAMILY PRACTICE PORTAGE, PORTAGE, MI 49024-4666
(269) 324-8950
(269) 324-2134
Mailing address
3300 W CENTRE AVE, PORTAGE, MI 49024-4666
(269) 324-8950
(269) 324-2134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101013940
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4720485
—
MI
01
—
CC3543
RAILROAD MEDICARE
MI
Enumeration date
01/25/2006
Last updated
11/27/2023
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