Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4301092803 | MI |
N | 208600000X | Surgeon | 4301092803 | MI |
Y | 2086S0120X | Pediatric Surgery | 4301092803 | MI |
NPI | 1518113315 |
---|---|
Provider Name | Matthew William Ralls |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2008 |
Last Update Date | 28/09/2020 |