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Organization
GREAT MIDWEST FOOT AND ANKLE CENTERS, S.C.
Active
Organization
GREAT MIDWEST FOOT AND ANKLE CENTERS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DONALD MATTEUCCI D.P.M. (PRESIDENT)
(414) 761-1613
Entity
Organization
Contact information
Practice address
320 W BROWN DEER RD, BAYSIDE, WI 53217-2319
(414) 761-0981
(414) 761-1614
Mailing address
8153 S 27TH ST, 400, FRANKLIN, WI 53132-9549
(414) 761-0981
(414) 761-1614
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43237400
—
WI
Enumeration date
07/27/2011
Last updated
01/12/2025
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