Provider Demographics
NPI:1649420217
Name:CAIN, MATTHEW (PA-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:CAIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1555 SOUTH BLVD E
Mailing Address - Street 2:STE 310
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5624
Mailing Address - Country:US
Mailing Address - Phone:248-215-8095
Mailing Address - Fax:248-289-6907
Practice Address - Street 1:3100 CROSS CREEK PKWY
Practice Address - Street 2:STE 200
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2774
Practice Address - Country:US
Practice Address - Phone:248-377-8000
Practice Address - Fax:248-377-2929
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2018-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601005351363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical