Provider Demographics
NPI:1508089426
Name:TATE, MATTHEW L (MD)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:L
Last Name:TATE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1440 E SHERMAN BLVD.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444
Mailing Address - Country:US
Mailing Address - Phone:231-672-2008
Mailing Address - Fax:231-672-2009
Practice Address - Street 1:1440 E SHERMAN BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444
Practice Address - Country:US
Practice Address - Phone:502-561-2700
Practice Address - Fax:502-561-2709
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2014-04-30
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Provider Licenses
StateLicense IDTaxonomies
KYR08952085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology