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Individual

DR. PRINCE PANNIPUZHA MATHEW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
8901 W LINCOLN AVE, AURORA HEALTH CARE, WEST ALLIS, WI 53227-2409
(414) 429-3071
Mailing address
W131N6589 CRESTWOOD DR, MENOMONEE FALLS, WI 53051-8315
(847) 414-1171

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57113-20
WI
208M00000X
Hospitalist Physician
Primary
57113
WI

Other

Enumeration date
09/26/2010
Last updated
12/02/2021
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