Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 4301500305 | MI |
Y | 213ES0000X | Sports Medicine | 4301500305 | MI |
NPI | 1306258322 |
---|---|
Provider Name | Dr. Matthew Thomas Santa Barbara |
First Address | Ann Arbor, MI 48104-6378 |
Second Address | Pittsburgh, PA 15232-1454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2014 |
Last Update Date | 11/10/2019 |