Provider Demographics
NPI:1811982804
Name:MCGEE, MATTHEW LAVIGNE (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:LAVIGNE
Last Name:MCGEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1950 E WATTLES RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-5099
Mailing Address - Country:US
Mailing Address - Phone:248-528-0050
Mailing Address - Fax:248-528-0909
Practice Address - Street 1:1950 E WATTLES RD
Practice Address - Street 2:SUITE 110
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-5099
Practice Address - Country:US
Practice Address - Phone:248-528-0050
Practice Address - Fax:248-528-0909
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2020-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301046108208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2506327071OtherBCBS OF MICHIGAN
MIF07214Medicare UPIN
MI2506327071OtherBCBS OF MICHIGAN