Individual
MATTHEW THOMAS GREULICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 DELAWARE ST SE, MMC 396, MINNEAPOLIS, MN 55455-0341
(612) 625-7692
Mailing address
201 N MAYFAIR RD, MMC 396, MILWAUKEE, WI 53226-4216
(414) 727-0910
(414) 727-0920
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
65334-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2011
Last updated
08/03/2016
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