Individual
FRANK R MATTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD, 4TH FL, GREEN BAY, WI 54311-6519
(920) 288-8400
Mailing address
2845 GREENBRIER RD, 4TH FL, GREEN BAY, WI 54311-6519
(920) 288-8400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
32595
WI
208000000X
Pediatrics Physician
Primary
32595-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32438200
—
WI
Enumeration date
01/09/2007
Last updated
04/13/2011
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