IndividualActive
Thomas Matelic, MD
NPI 1700873874 · Sports Medicine (Orthopaedic Surgery) Physician · Grand Rapids, MI
Provider details
- NPI number
- 1700873874
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 4301054564 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1111 Leffingwell Ave Ne
Ste 100
Grand Rapids, MI 49525-6406
Phone: (616) 459-7101
Approximate (ZIP-level) locationGet directions
Mailing address
1111 Leffingwell Ave Ne
Grand Rapids, MI 49525-6406
Registry dates
- Enumerated
- 2005-10-04
- Last updated
- 2013-03-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.