Individual
FREDERIC HOWARD MATTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3900 SUNFOREST CT STE 136, TOLEDO, OH 43623-4440
(419) 474-1104
(419) 473-2867
Mailing address
3036 W SYLVANIA AVE, TOLEDO, OH 43613-4128
(419) 473-0431
(419) 471-2460
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35-045049M
OH
2085R0202X
Diagnostic Radiology Physician
35045049M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0439298
—
OH
Enumeration date
07/21/2006
Last updated
07/08/2007
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