Individual
MATTHEW C NIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-2200
Mailing address
1515 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-2200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
54971
WI
Other
Enumeration date
07/15/2009
Last updated
11/27/2023
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