Individual
MATTHEW S BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-7888
(920) 563-7741
Mailing address
PO BOX 249, FORT ATKINSON, WI 53538-0249
(920) 568-5411
(920) 568-4004
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
45463-020
WI
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
45463-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34405300
—
WI
01
—
60102
DEAN HEALTH INSURANCE
WI
Enumeration date
06/01/2006
Last updated
10/07/2022
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