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Individual

GREGORY J MATTHEWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9233 N GREEN BAY RD, BROWN DEER, WI 53209-1103
(414) 270-8150
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 270-8150

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32337
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31730700
WI
Enumeration date
06/09/2006
Last updated
06/12/2012
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