Individual
MATTHEW TYLER KROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 430-4700
Mailing address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 430-4700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
81365-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2021
Last updated
07/03/2024
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