Individual
DR. VINCENT P MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3750
(414) 259-9290
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3750
(414) 259-9290
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01036675A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
61934
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000248977
ANTHEM-351158723
IN
01
—
000000492358
ANTHEM 203778927
IN
01
—
020170
SIHO-351158723
IN
05
—
1033190624
—
WI
01
—
108061
HEALTH ALLIANCE-351158723
IN
05
—
200067870
—
IN
01
—
300136991
RR MEDICARE-351158723
IN
01
—
Q0071557
CMOSHO351158723&352047427
IN
Enumeration date
11/09/2005
Last updated
06/24/2015
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