Individual
DR. JINU JACOB MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1121 E NORTH AVE, MILWAUKEE, WI 53212-3515
(414) 267-6500
Mailing address
1152 E WALWORTH ST, MILWAUKEE, WI 53212-3521
(414) 276-4174
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
49749
WI
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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