Individual
THOMAS G. MATKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3811 SPRING ST, STE 202, RACINE, WI 53405-1667
(262) 687-8202
Mailing address
3811 SPRING ST, STE 202, RACINE, WI 53405-1667
(262) 687-8202
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
43406-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34120500
—
WI
Enumeration date
07/23/2006
Last updated
02/23/2023
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