Provider Demographics
NPI:1225535131
Name:ENGMANN, MATHEW DONALD (DO)
Entity Type:Individual
Prefix:
First Name:MATHEW
Middle Name:DONALD
Last Name:ENGMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1121 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-3515
Mailing Address - Country:US
Mailing Address - Phone:414-267-6502
Mailing Address - Fax:414-267-3892
Practice Address - Street 1:1121 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-3515
Practice Address - Country:US
Practice Address - Phone:414-267-6502
Practice Address - Fax:414-267-3892
Is Sole Proprietor?:No
Enumeration Date:2018-04-07
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI72928207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine