Organization
JOHN C MATTEUCCI JR MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C MATTEUCCI JR. MD (PRESIDENT)
(262) 653-9221
Entity
Organization
Contact information
Practice address
6127 GREEN BAY ROAD, SUITE 600, KENOSHA, WI 53142-2973
(262) 653-9221
(262) 653-9229
Mailing address
6127 GREEN BAY ROAD, SUITE 600, KENOSHA, WI 53142-2973
(262) 653-9221
(262) 653-9229
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
08/31/2007
Last updated
08/31/2007
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