MICHAEL JOHN MATTINGLY (NPI# 1588607964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588607964 |
| Entity Type | Individual |
| Full Name | MICHAEL JOHN MATTINGLY |
| Credential | DO |
| Practice Address |
1000 Harrington Blvd Mt Clemens MI 48043 |
| Mailing Address |
8573 Reliable Parkway Chicago IL 60686 |
| Practice Telephone | 5864938000 |
| Mailing Telephone | 8668987139 |
| Mailing Fax Number | 6169759824 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2008-05-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 5101013572 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | MM013572 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720200165 | Michael Mattingly | Dentist | 3255 Lyndale Ave S, Minneapolis, MN 55408-3647 | 2007-05-03 |
| 1639533730 | Michael Mattingly | Family Medicine | 1500 S Main St, Fort Worth, TX 76104-4917 | 2016-04-05 |
| 1659549681 | Michael C Mattingly | Pediatrics | 401 Baptist Dr Ste 301, Madison, MS 39110-2012 | 2008-02-12 |
| 1477592673 | Michael T Mattingly | Internal Medicine | 309 New St, Greensboro, NC 27405-3654 | 2006-06-05 |
| Street Address |
1000 HARRINGTON BLVD |
| City | MT CLEMENS |
| State | MI |
| Zip Code | 48043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235637315 | Stefania A Faylor | Nurse Anesthetist, Certified Registered | 1000 Harrington Blvd, Mt Clemens, MI 48043-2920 | 2018-01-24 |
| 1912160383 | Rebekah Eskew Latham | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2008-07-07 |
| 1932294881 | Stanley Anthony Materka | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-10-04 |
| 1053325886 | Ali M. Saad Do PC | Emergency Medicine | 1000 Harrington Blvd, Mount Clemens Regional Medical Center, Mt Clemens, MI 48043 | 2006-07-28 |
| 1609890441 | Ali Mohammed Saad | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens Regional Medical Center, Mt Clemens, MI 48043 | 2006-07-26 |
| 1396773867 | Pathology Associates of Mt Clemens PC | Pathology | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-30 |
| 1295771491 | Richard A Reidy | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-22 |
| 1013953298 | Glenn A Delong | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-22 |
| 1891731980 | Michael Warren Tawney | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-20 |
| 1972547883 | Michael Jon Kitto | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699300228 | Blue Diamond Aba Services LLC | Assistant Behavior Analyst | 102 North Avenue, Mt. Clemens, MI 48043 | 2020-03-04 |
| 1265086136 | Venture Counseling | Social Worker | 198 S. Main Street, Suite 2, Mount Clemens, MI 48043 | 2019-07-30 |
| 1386203651 | Michele Lee Casebolt | Physical Therapist | 30795 Twenty Three Mile Rd., Chesterfield, MI 48043 | 2019-06-11 |
| 1730669706 | Wynn A Mitchell | Case Manager/Care Coordinator | 24 Hubbard St, Mount Clemens, MI 48043 | 2018-08-18 |
| 1629520101 | Boitshoko Marang | Family Medicine | Clinton River Drive 11a, Mount Clemens, MI 48043 | 2016-10-31 |
| 1720332265 | New Passages | Point of Service | 175 N. Grorsebeck Hwy, Mt. Clemens, MI 48043 | 2012-11-06 |
| 1376807784 | Christopher John Shamass | Emergency Medicine | 1000 Harrington Boulevard, Mount Clemens, MI 48043 | 2012-06-29 |
| 1265749683 | Mycare Health Center | Clinic/Center | 18 Market Street, Suite C, Mount Clemens, MI 48043 | 2010-09-07 |
| 1114102837 | George Edward Perron | Family Medicine | 256 Wellington Crescent, Mt Clemens, MI 48043 | 2007-12-31 |
| 1558568733 | Dawood Ghassan Dalaly | Surgery | 1000 Harrington, Mt Clemens, MI 48043 | 2007-06-29 |
| Find all providers in zip 48043 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912160383 | Rebekah Eskew Latham | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2008-07-07 |
| 1932294881 | Stanley Anthony Materka | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-10-04 |
| 1053325886 | Ali M. Saad Do PC | Emergency Medicine | 1000 Harrington Blvd, Mount Clemens Regional Medical Center, Mt Clemens, MI 48043 | 2006-07-28 |
| 1609890441 | Ali Mohammed Saad | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens Regional Medical Center, Mt Clemens, MI 48043 | 2006-07-26 |
| 1295771491 | Richard A Reidy | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-22 |
| 1013953298 | Glenn A Delong | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-22 |
| 1891731980 | Michael Warren Tawney | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-20 |
| 1972547883 | Michael Jon Kitto | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-15 |
| 1710921630 | James M Larkin | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-15 |
| 1407898737 | William Birol Halacoglu | Emergency Medicine | 1000 Harrington Blvd, Mt Clemens, MI 48043 | 2006-06-12 |
| Find all providers in MT CLEMENS | ||||
| City | MT CLEMENS |
| Zip Code | 48043 |
Please comment or provide details below to improve the information on MICHAEL JOHN MATTINGLY.
| 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.