Provider Demographics
NPI:1366094435
Name:AMAN, MATTHEW LEONARD
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:LEONARD
Last Name:AMAN
Suffix:
Gender:M
Credentials:
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27483 DEQUINDRE RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-5715
Mailing Address - Country:US
Mailing Address - Phone:248-967-7769
Mailing Address - Fax:248-547-5696
Practice Address - Street 1:135 BARCLAY CIR STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4599
Practice Address - Country:US
Practice Address - Phone:248-852-2277
Practice Address - Fax:833-533-4924
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704293315363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology