Individual
MATTHEW THOMAS STAGL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1032 E SUMNER ST, HARTFORD, WI 53027-1608
(262) 673-2300
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
83857
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100279173
—
WI
Enumeration date
04/26/2021
Last updated
10/15/2024
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