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

MARINA MATTA, PHYSICIAN ASSISTANT

Active Sole Proprietor

MARINA MATTA, PHYSICIAN ASSISTANT is a Physician Assistant healthcare provider located in GROSSE POINTE FARMS, Michigan. NPI 1053953273 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · GROSSE POINTE FARMS, MI

Registration Details

NPI Number
1053953273
Provider Type
Individual
Gender
Female
NPI Issued
Oct 9, 2019 (6.8046903433473 yrs)
Last Updated
Feb 17, 2026
Sole Proprietor
Yes

Practice Information

Address
17108 MACK AVE STE 108
GROSSE POINTE FARMS, MI, 482306224
Browse MI providers · Browse ZIP 48230
Phone
3137232572
Primary Specialty
Physician Assistant
363A00000X

Other Physician Assistant Providers in GROSSE POINTE FARMS, MI

Name Credential NPI
MS. DEBRA E EVOLA P.A.-C. 1457492761
RALEIGH D ECKERT PA, MSPH 1487139929
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.