Individual
MATTHEW STEVEN JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2301 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 585-1000
Mailing address
111 E WISCONSIN AVE STE 2100, MILWAUKEE, WI 53202-4809
(414) 290-6700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301105535
MI
207P00000X
Emergency Medicine Physician
Primary
67108-20
WI
Other
Enumeration date
06/11/2014
Last updated
12/31/2021
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