Provider Demographics
NPI:1386922268
Name:MATRIX ANESTHESIA PLC
Entity type:Organization
Organization Name:MATRIX ANESTHESIA PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:PAPENFUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-792-4090
Mailing Address - Street 1:4450 FASHION SQUARE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1251
Mailing Address - Country:US
Mailing Address - Phone:989-792-4090
Mailing Address - Fax:989-792-4094
Practice Address - Street 1:4450 FASHION SQUARE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-1251
Practice Address - Country:US
Practice Address - Phone:989-792-4090
Practice Address - Fax:989-792-4094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty