Provider Demographics
NPI:1891924049
Name:HOLEN, MATTHEW G (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:G
Last Name:HOLEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:804 SERVICE RD STE A202
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-975-8930
Mailing Address - Fax:517-337-4985
Practice Address - Street 1:274 EAST CHICAGO STREET
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:51727-5476
Practice Address - Country:US
Practice Address - Phone:517-279-5476
Practice Address - Fax:248-338-5567
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2024-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI51010182872085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology