Individual
MATTHEW ERIC STAUFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(414) 290-6720
(414) 290-6755
Mailing address
111 E WISCONSIN AVE, SUITE 2000, MILWAUKEE, WI 53202-4815
(414) 290-6720
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301097287
MI
207P00000X
Emergency Medicine Physician
Primary
61053-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
4301097287
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497066732
—
IL
05
—
1497066732
—
WI
01
—
P01269460
MEDICARE RAILROAD
WI
01
—
P01319713
MEDICARE RAILROAD
WI
Enumeration date
07/01/2010
Last updated
05/07/2015
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