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Individual

DR. MATTHEW REED WILLSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 828-2530
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 828-2530

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
60809
WI
207XS0106X
Orthopaedic Hand Surgery Physician
60809-21
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100030930
WI
Enumeration date
07/18/2007
Last updated
10/19/2023
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