Individual
MATTHEW GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-3000
(920) 320-3049
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2591
(920) 320-5102
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
45443
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34363100
—
WI
01
—
P00213343
RAILROAD MEDICARE
WI
Enumeration date
08/30/2006
Last updated
03/04/2015
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