Most Relevant Information
Provider Data
| NPI Number: | 1003699265 |
| Provider Name: | SARAH ANNE MATTAN PA |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 5601012142 |
Most Important Dates
| Enumeration Date: | 08/14/2023 |
| Last Updated: | 03/24/2024 |
Provider Practice Location
18621 E 9 MILE RD
EASTPOINTE
MI
480211953
Practice Location Phone/Fax
| Phone: | 5869440099 |
| Fax: |
Provider Mailing Location
1675 LEAHY ST STE 315A
MUSKEGON
MI
494425543
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |