Individual
DR. MITHIN MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6308 8TH AVE, KENOSHA, WI 53143-5031
(224) 551-8030
Mailing address
4001 N 3RD ST STE 290, PHOENIX, AZ 85012-2071
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
81607-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2021
Last updated
08/02/2024
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