Individual
DR. EMILY ROSE MATTOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-0812
(414) 805-0855
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-0812
(414) 805-0855
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
82165
WI
208M00000X
Hospitalist Physician
Primary
82165
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982199808
—
WI
05
—
200061064
—
MO
Enumeration date
06/22/2018
Last updated
08/22/2023
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