Mataczynski, James Dean

Mataczynski, James Dean is an sole proprietor health care provider with primary practice located at 3805B Spring St Suite 250, Mount Pleasant WI 53405-1641. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mataczynski, James Dean can be contacted via phone (262) 634-6679.

Contact Information

Primary practice address
3805B Spring St Suite 250 Mount Pleasant WI 53405-1641
Phone: (262) 634-6679
Fax: (262) 634-7935
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 31067 020 Wisconsin

Profile Details

NPI number 1285613109
LBN Legal business name Mataczynski, James Dean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2006
Last updated Apr 22nd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285613109 NPPES
Wisconsin MEDICAID 31598100

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