Individual
KATHERINE MATTHEWS EICHTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11040 N STATE ROAD 77, HAYWARD, WI 54843-3606
(715) 934-4321
Mailing address
11040 N STATE ROAD 77, HAYWARD, WI 54843-3606
(715) 934-4321
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
53750-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073735056
MEDICA
—
01
—
16P72EI
BCBS
MN
05
—
762957000
—
MN
01
—
P00436682
RR MEDICARE PTAN
—
Enumeration date
05/02/2007
Last updated
07/07/2020
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