Matasar, Kenneth
Matasar, Kenneth is an individual health care provider with primary practice located at 3601 W 13 Mile Rd , Royal Oak MI 48073-6712. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Matasar, Kenneth can be contacted via phone (248) 898-6067.Contact Information
Primary practice address
3601 W 13 Mile Rd
Royal Oak MI 48073-6712
Phone: (248) 898-6067
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 4301032306 | Michigan |
Profile Details
| NPI number | 1689634461 |
|---|---|
| LBN Legal business name | Matasar, Kenneth |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689634461 | NPPES |
| Michigan | MEDICAID | 1577939 |
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