Individual
MATTHEW DEGROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2000
Mailing address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
390200000X
IL
207P00000X
Emergency Medicine Physician
Primary
75660
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100171155
—
WI
Enumeration date
04/06/2018
Last updated
06/26/2023
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