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Individual

DR. JAMES DEAN MATACZYNSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3805B SPRING ST, SUITE 250, MOUNT PLEASANT, WI 53405-1641
(262) 634-6679
(262) 634-7935
Mailing address
3805B SPRING ST, SUITE 250, MOUNT PLEASANT, WI 53405-1641
(262) 634-6679
(262) 634-7935

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31067 020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31598100
WI
Enumeration date
01/10/2006
Last updated
04/22/2015
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