DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MATTHEW A STACK, PA C

Active

MATTHEW A STACK, PA C is a Physician Assistant healthcare provider located in ITHACA, Michigan. NPI 1033108667 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · ITHACA, MI

Registration Details

NPI Number
1033108667
Provider Type
Individual
Gender
Male
NPI Issued
Oct 17, 2005 (20.643824135315 yrs)
Last Updated
Feb 5, 2026
Licenses
6301007939 (MI)
2782 (AZ)
5601003961 (MI)

Practice Information

Address
121 N PINE RIVER ST
ITHACA, MI, 488471039
Browse MI providers · Browse ZIP 48847
Phone
9892870662
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Medical Physician Assistant
Additional Specialty
Physician Assistant
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in ITHACA, MI

Name Credential NPI
MR. THOMAS J KNIGHT PA C 1396719878
CATHERINE MARIE CHIMO PA 1508896523
CRYSTAL MORRISSEY PA-C 1497900591
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.