Individual
EVA T MATANGUIHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2031 PEACH ST, WISCONSIN RAPIDS, WI 54494-5181
(715) 423-0122
Mailing address
2031 PEACH ST, WISCONSIN RAPIDS, WI 54494-5181
(715) 423-0122
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36788
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32164100
—
WI
Enumeration date
08/13/2006
Last updated
04/11/2012
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