Individual
MATTHEW T TALLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC ALLERGY AND IMMUNOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-6840
(414) 266-6437
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC ALLERGY AND IMMUNOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-6840
(414) 266-6437
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
55777
WI
208000000X
Pediatrics Physician
55777
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376785691
—
WI
Enumeration date
04/01/2009
Last updated
03/13/2024
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