Individual
MR. MATTHEW ROBERT BONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 544-5311
(262) 544-6820
Mailing address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 303-5055
(262) 303-5057
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
49242
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588627368
—
WI
05
—
34873700
—
WI
Enumeration date
04/11/2006
Last updated
03/07/2023
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