Individual provider · Type 1 NPI
Michael Leroy Matteson, PA C
Surgical Physician Assistant · Carbondale, IL
NPI number
1033386115
Active
Practice location
305 W Jackson St, Suite 105
Carbondale, IL 62901-1474
Fax (618) 536-2835
Mailing address
PO Box 1105
Indianapolis, IN 46206-1105
Other practice locations
- 2006 Health Campus Dr Ste 200, Rockingham, VA 22801-8679 · (540) 689-5555
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 0110003884 (VA) |
| Surgical Physician Assistant Primary | 363AS0400X | 385000710 (IL) |
Surgical Physician Assistant: Definition to come...
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About NPI 1033386115
Michael Leroy Matteson, PA C's National Provider Identifier is 1033386115, issued on May 8, 2008. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Carbondale, IL. The record was last updated on Dec 8, 2025.