Individual
DR. MATTHEW DAVID WONCHALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
W231N1440 CORPORATE CT, WAUKESHA, WI 53186-1303
(262) 896-6000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
101844
WI
2085R0202X
Diagnostic Radiology Physician
4301502914
MI
2085R0202X
Diagnostic Radiology Physician
4351031905
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100281813
—
WI
Enumeration date
06/07/2018
Last updated
09/10/2024
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