Individual
MATTHEW DAVID AMIDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-3360
(414) 266-3563
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-3360
(414) 266-3563
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
125.064656
IL
208000000X
Pediatrics Physician
Primary
67233
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164834735
—
WI
Enumeration date
05/29/2014
Last updated
07/28/2020
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