Individual
DR. RANDY C MATHEWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6601 NORTHWAY # D, GREENDALE, WI 53129-1830
(414) 423-0555
(414) 423-8268
Mailing address
5745 GLADSTONE LN, GREENDALE, WI 53129-1512
(414) 423-0555
(414) 423-8268
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23146
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30436400
—
WI
Enumeration date
09/26/2006
Last updated
07/09/2007
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