Stephen J Mattichak
Interventional Cardiology Internist - Cardiovascular Disease and 1 more
1775 Thompson Rd
Coos Bay
, Oregon 97420-2125
Stephen J Mattichak
Interventional Cardiology Internist - Cardiovascular Disease and 1 more
1775 Thompson Rd
Coos Bay
, Oregon 97420-2125
(810) 342-1591
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About
Features
Specialties
- Internist - Cardiovascular Disease
- Interventional Cardiology
Languages spoken
- English
Location
First Address
- Stephen J Mattichak
- 401 S. Ballenger Hwy
- Flint, MI
- Zip : 48532-3638
- Fax : (810) 342-1591
- Phone : (810) 342-1000
Second Address
- Stephen J Mattichak
- 1775 Thompson Rd
- Coos Bay, OR
- Zip : 97420-2125
- Phone : (541) 269-8111
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RC0000X | Internist - Cardiovascular Disease | 35.132423 | OH |
| Y | 207RC0000X | Internist - Cardiovascular Disease | 4301079048 | MI |
| N | 207RC0000X | Internist - Cardiovascular Disease | DR.0059344 | CO |
| N | 207RI0011X | Interventional Cardiology | 35.132423 | OH |
| N | 207RI0011X | Interventional Cardiology | DR.0059344 | CO |
National Provider Identifier
| NPI | 1013930189 |
|---|---|
| Provider Name | Stephen J Mattichak |
| First Address | Flint, MI 48532-3638 |
| Second Address | Coos Bay, OR 97420-2125 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/07/2006 |
| Last Update Date | 01/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0258031 | (05) | OH |
| 4839590 | (05) | MI |
| 500778985 | (05) | OR |
| H13704 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.