MATTHEW A MAZUR (NPI# 1376719781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376719781 |
| Entity Type | Individual |
| Full Name | MATTHEW A MAZUR |
| Credential | D.O. |
| Practice Address |
829 N Center Ave Suite 140 Gaylord MI 49735-1595 |
| Mailing Address |
850 N Otsego Ave Suite 1 Gaylord MI 49735-1568 |
| Practice Telephone | 9897317870 |
| Practice Fax Number | 9897317837 |
| Mailing Telephone | 9897317708 |
| Mailing Fax Number | 9897317929 |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2019-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 510102814 | MI | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 036119681 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 2220936 | 01 |
| IL | 1376719781 1 | 05 | |
| MI | MEDICARE GROUP NUMBER | OF96004 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174143788 | Matthew Mazur | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2020-04-23 |
| 1275168791 | Matthew Mazur | Pharmacist | 2050 Lime Kiln Rd, Green Bay, WI 54311-6264 | 2020-03-04 |
| Street Address |
829 N CENTER AVE SUITE 140 |
| City | GAYLORD |
| State | MI |
| Zip Code | 49735-1595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598754715 | Luis Raul Collazo | Pediatrics | 829 N Center Ave, Suite 130, Gaylord, MI 49735-1595 | 2005-10-20 |
| 1174043889 | Michael D Katona | Nurse Practitioner | 829 N Center Ave, Gaylord, MI 49735-1595 | 2017-06-23 |
| 1114303575 | Brittanie Hamlin | Physician Assistant | 829 N Center Ave, Gaylord, MI 49735-1595 | 2015-08-07 |
| 1326443722 | Coleman Gulick | Nurse Practitioner | 829 N Center Ave, Gaylord, MI 49735-1595 | 2014-10-28 |
| 1720417694 | Kristy J. Alexander | Nurse Practitioner | 829 N Center Ave, Suite 200, Gaylord, MI 49735-1595 | 2013-11-01 |
| 1235401712 | John Matthew Lawrence | Physician Assistant | 829 N Center Ave, Suite 210, Gaylord, MI 49735-1595 | 2012-01-31 |
| 1043505399 | Yelena V Isayenko | Family Medicine | 829 N Center Ave, Suite 210, Gaylord, MI 49735-1595 | 2011-06-15 |
| 1598073801 | Shawn M Bahleda | Physician Assistant | 829 N Center Ave, Gaylord, MI 49735-1595 | 2010-09-21 |
| 1942511126 | Amanda Lee Williams | Pediatrics | 829 N Center Ave, Suite 130, Gaylord, MI 49735-1595 | 2010-06-23 |
| 1639301724 | Ronald Frank Applebey | Physician Assistant | 829 N Center Ave, Suite 210, Gaylord, MI 49735-1595 | 2009-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447453 | Jenni Kirt | Social Worker | 407 I-75 Bus N, Gaylord, MI 49735 | 2020-11-05 |
| 1922584986 | Patricia Dovalina | Behavior Technician | 2285 Michaywe Dr, Otsego Lake, MI 49735 | 2018-07-12 |
| 1265944581 | James Hulbert | Social Worker | 407 W Main Street, Gaylord, MI 49735 | 2017-10-26 |
| 1548792625 | Somer Lawes | Behavior Technician | 2443 Castlewood Dr, Gaylord, MI 49735 | 2017-03-29 |
| 1922554161 | Mark David Mcpherson | Counselor | 2136 West M-32, Gaylord, MI 49735 | 2016-08-28 |
| 1689063034 | Liza Brandt | Behavioral Analyst | 6748 Colonial Ct, Gaylord, MI 49735 | 2015-01-22 |
| 1942597224 | Visions for Your Community Care Hhc | Home Health | 2365 N Perch Lake Dr, Gaylord, MI 49735 | 2011-07-07 |
| 1073778304 | Julie Lynn Vandusen | Community Health Worker | 5512 Clubhouse Trail, Gaylord, MI 49735 | 2008-07-25 |
| 1073708798 | Alpine Chiropractic, PC | Chiropractor | 529 S. Wisconsin Ave, Gaylord, MI 49735 | 2007-09-06 |
| 1669675567 | Oral and Maxillofacial Surgery Associates | Dentist | 785 E M32, Gaylord, MI 49735 | 2007-06-07 |
| Find all providers in zip 49735 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851690341 | Patricia Duley Mdpc | Internal Medicine | 606 N Court Ave, Gaylord, MI 49735-1516 | 2011-03-23 |
| 1144628447 | Pine Trees Medical Office, P.C. | Internal Medicine | 604 W Main St, Ste B, Gaylord, MI 49735-1869 | 2014-12-18 |
| 1952564213 | Jennifer Lawhorn | Internal Medicine | 701 N Otsego Ave, Gaylord, MI 49735-1558 | 2008-07-08 |
| 1518035468 | Stephen M Ward | Internal Medicine | 829 N Center Ave, Suite 140, Gaylord, MI 49735-1595 | 2006-11-30 |
| 1104851658 | Steven John Wisniewski | Internal Medicine | 829 N Center Ave, Suite 140, Gaylord, MI 49735-1595 | 2006-07-12 |
| 1912938689 | Gregory Joseph Trudell | Internal Medicine | 806 S Otsego Ave, Gaylord, MI 49735-1725 | 2006-07-05 |
| 1114958899 | Changxin Li | Internal Medicine | 829 N Center Ave, Suite 140, Gaylord, MI 49735-1595 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910687 | Berry Johnson Health Pllc | Internal Medicine | 30123 Rock Creek Dr, Southfield, MI 48076-5358 | 2020-10-24 |
| 1386243178 | Hoover Internal Medicine Pllc | Internal Medicine | 4067 Georgia St, Hamtramck, MI 48212 | 2020-10-22 |
| 1790399798 | Enhua Wang | Internal Medicine | 1215 E Michigan Ave Ste 500, Lansing, MI 48912-1811 | 2020-09-07 |
| 1093329849 | Hey Doc, P.C. | Internal Medicine | 1431 Washington Blvd Apt 2510, Detroit, MI 48226-1729 | 2020-08-31 |
| 1568074375 | Mohammad Nadeemullah Pllc | Internal Medicine | 5400 Waldenhill Ct, Superior Twp, MI 48198-9654 | 2020-08-21 |
| 1356953723 | Eager Internal Medicine, Pllc | Internal Medicine | 720 N Lapeer Rd Ste 101, Lake Orion, MI 48362-4011 | 2020-08-18 |
| 1144838335 | Ranim Chamseddin | Internal Medicine | 3200 Five Points Dr Unit 110, Auburn Hills, MI 48326-2372 | 2020-07-14 |
| 1407474562 | Pravalika Rudraraju | Internal Medicine | 6245 Inkster Rd Dept Of, Garden City, MI 48135-4001 | 2020-07-06 |
| 1780200469 | Abed L Dabaja | Internal Medicine | 6245 Inkster Rd # Gme, Garden City, MI 48135-4001 | 2020-06-18 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.