Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist | ||
N | 224P00000X | Prosthetist |
NPI | 1215586623 |
---|---|
Provider Name | Matthew Mcewin |
First Address | Sterling Heights, MI 48314-3751 |
Second Address | Sterling Heights, MI 48314-3751 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2019 |
Last Update Date | 09/09/2019 |