Individual
DR. MATTHEW CARL SARDELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5680 BOW POINTE DR STE 102, CLARKSTON, MI 48346-5407
(248) 792-0037
Mailing address
5701 BOW POINTE DR STE 300, CLARKSTON, MI 48346-5402
(248) 792-0037
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301084379
MI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
4301084379
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N45090
GRP MEDICARE
MI
05
—
1992992705
—
MI
Enumeration date
09/26/2007
Last updated
11/04/2024
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