Provider Demographics
NPI:1295909539
Name:ANDRESEN, MATTHEW CARL (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:CARL
Last Name:ANDRESEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8075 TOWN CENTRE DR STE E
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-4011
Mailing Address - Country:US
Mailing Address - Phone:440-717-6100
Mailing Address - Fax:440-546-1382
Practice Address - Street 1:8075 TOWN CENTRE DR STE E
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-4011
Practice Address - Country:US
Practice Address - Phone:440-717-6100
Practice Address - Fax:440-546-1382
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.097756207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine