Theado, Matthew R.
Theado, Matthew R. is an individual health care provider with primary practice located at 555 Redbird Cir Suite 200, De Pere WI 54115-7977. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Theado, Matthew R. can be contacted via phone (920) 338-6820.Contact Information
Primary practice address
555 Redbird Cir Suite 200
De Pere WI 54115-7977
Phone: (920) 338-6820
Fax: (920) 338-6829
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 39636 | Wisconsin |
Profile Details
| NPI number | 1235149139 |
|---|---|
| LBN Legal business name | Theado, Matthew R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Oct 11th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235149139 | NPPES |
| Wisconsin | MEDICAID | 32447000 |
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Hoyman, Sherri L
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