Individual
MATTHEW KOEBERL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 WESTERN AVE, LAKESHORE RADIOLOGY, MANITOWOC, WI 54220
(920) 320-3800
Mailing address
2300 WESTERN AVE, LAKESHORE RADIOLOGY, MANITOWOC, WI 54220
(414) 429-0662
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
55016
WI
Other
Enumeration date
07/15/2009
Last updated
03/22/2021
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