Small, Matthew G

Small, Matthew G is an individual health care provider with primary practice located at 965 S Bailey Ave Suite 2-1, South Haven MI 49090-9701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Small, Matthew G can be contacted via phone (269) 639-2772.

Contact Information

Primary practice address
965 S Bailey Ave Suite 2-1 South Haven MI 49090-9701
Phone: (269) 639-2772
Fax: (269) 639-2770
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301083155 Michigan

Profile Details

NPI number 1336168871
LBN Legal business name Small, Matthew G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Nov 30th, 2016 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1336168871 NPPES
Michigan MEDICAID 4628853 T10

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