Green, Michael Matthew
Green, Michael Matthew is an individual health care provider with primary practice located at 81 N Mario Capecchi Dr Department Of Pediatrics, Salt Lake City UT 84113-1125. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine, Allopathic & Osteopathic Physicians / Brain Injury Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine is his primary health care specialty. Green, Michael Matthew can be contacted via phone (801) 213-7737.Contact Information
Primary practice address
81 N Mario Capecchi Dr Department Of Pediatrics
Salt Lake City UT 84113-1125
Phone: (801) 213-7737
Fax: (801) 587-7539
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | BP10031712 | Texas |
| Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine | 2081P0010X | 2011017820 | Missouri |
| Allopathic & Osteopathic Physicians / Brain Injury Medicine | 2081P0301X | 8728465-1204 | Utah |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine | 2081P0010X | 8728465-1204 | Utah |
Profile Details
| NPI number | 1063665719 |
|---|---|
| LBN Legal business name | Green, Michael Matthew |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 28th, 2008 |
| Last updated | Dec 10th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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