Individual
MATTHEW BRIAN KOWALKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4061 OLD PESHTIGO RD, MARINETTE, WI 54143-3887
(715) 732-8000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
149932
FL
207R00000X
Internal Medicine Physician
Primary
21645
WI
207R00000X
Internal Medicine Physician
ME149932
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100189732
—
WI
Enumeration date
04/03/2018
Last updated
12/26/2024
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