| Matthew Rushlau Edd, Llc | |
|
4031 W Main St Ste 400 Kalamazoo MI 49006-3730 | |
| (269) 567-4202 | |
| (269) 344-8696 |
| Full Name | Matthew Rushlau Edd, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4031 W Main St Ste 400, Kalamazoo, Michigan |
| Authorized Official Name and Position | Matthew Rushlau (OWNER) |
| Authorized Official Contact | 2695675912 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Rushlau Edd, Llc 4021 W Main St Ste 100 Kalamazoo MI 49006-3706 Ph: (269) 384-6055 | Matthew Rushlau Edd, Llc 4031 W Main St Ste 400 Kalamazoo MI 49006-3730 Ph: (269) 567-4202 |
| NPI Number | 1982898292 |
|---|---|
| Provider Enumeration Date | 08/29/2007 |
| Last Update Date | 07/07/2022 |
| Certification Date | 07/07/2022 |
| Medicare PECOS PAC ID | 3274628854 |
|---|---|
| Medicare Enrollment ID | O20070927000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982898292 | NPI | - | NPPES |
| 680C912030 | Other | MI | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301010494 (Michigan) | Primary |
| Provider Name | Matthew G Rushlau |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548385792 PECOS PAC ID: 5193810778 Enrollment ID: I20070927000194 |
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