Basic Information
| Provider Information | |||||||||
| NPI: | 1508089426 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TATE | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1440 E SHERMAN BLVD. | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2316722008 | ||||||||
| FaxNumber: | 2316722009 | ||||||||
| Practice Location | |||||||||
| Address1: | 1440 E SHERMAN BLVD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025612700 | ||||||||
| FaxNumber: | 5025612709 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2007 | ||||||||
| LastUpdateDate: | 04/30/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | R0895 | KY | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.