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Individual

DR. MATTHEW BRENDON COLLIGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1715 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 496-4700
Mailing address
1715 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
OS9282
FL
207X00000X
Orthopaedic Surgery Physician
5101014350
MI
207X00000X
Orthopaedic Surgery Physician
Primary
63648-21
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
270390400
FL
05
4820631
MI
Enumeration date
06/16/2005
Last updated
03/26/2015
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