Provider Demographics
NPI:1528680303
Name:MATTIOLI, EMILIA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:EMILIA
Middle Name:ELIZABETH
Last Name:MATTIOLI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2283 KNOB HILL DR APT 6
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-4562
Mailing Address - Country:US
Mailing Address - Phone:906-250-3385
Mailing Address - Fax:
Practice Address - Street 1:965 FEE ROAD ROOM A223
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824
Practice Address - Country:US
Practice Address - Phone:517-353-4362
Practice Address - Fax:517-432-0927
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43510469912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry