Basic Information
Provider Information
NPI: 1386853539
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARENS
FirstName: MATTHEW
MiddleName: JOSEPH
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3415 FAIRMONT RD. APT. 10
Address2:  
City: ROYAL OAK
State: MI
PostalCode: 48073
CountryCode: US
TelephoneNumber: 6082178011
FaxNumber:  
Practice Location
Address1: 6071 W OUTER DR
Address2:  
City: DETROIT
State: MI
PostalCode: 482352624
CountryCode: US
TelephoneNumber: 3139663300
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/22/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XNONEMIY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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