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Contact Information

ADNAN MATTA MD PC
4090 E 14 MILE RD STE 100
WARREN, MI48092-1196
 Phone: 586-838-4441
 Fax: 586-838-4641
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for ADNAN MATTA MD PC

NPI # 1922265982
LBN Legal business name ADNAN MATTA MD PC
Authorized official ADNAN MATTA - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/19/2008
Last updated 01/16/2025 - More than a year ago
Identifiers
MI License # 4301034389
MI Medicaid 101701996
MI Other 0206353551 BCBS
MI Other ========= COMMERCIAL
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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