Individual
DR. HANI S MATLOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1155 N MAYFAIR RD, PLASTIC SURGERY CENTER, MILWAUKEE, WI 53226-3462
(414) 955-1000
(414) 955-0183
Mailing address
1155 N MAYFAIR RD, PLASTIC SURGERY CENTER, MILWAUKEE, WI 53226-3462
(414) 955-1000
(414) 955-0183
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
21948
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000126C
HUMANA
—
05
—
1316998164
—
WI
Enumeration date
05/15/2006
Last updated
05/01/2020
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