| Organization Name: | ADNAN MATTA MD PC |
| NPI Number: | 1922265982 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ADNAN H MATTA (PRESIDENT) |
| Mailing Address: | 44555 Woodward #106 Pontiac |
| State: | MI US |
| Postal Code: | 48341 |
| Phone Number: | 2488583060 |
| Fax Number: | 2488583520 |
| NPI Enumeration Date: | 05/19/2008 |
| NPI Last Update Date: | 06/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301034389 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |