Provider Demographics
NPI:1275737199
Name:HERALD, MATTHEW R (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:R
Last Name:HERALD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:721 AMERICAN AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-5071
Mailing Address - Country:US
Mailing Address - Phone:262-928-7528
Mailing Address - Fax:262-928-5096
Practice Address - Street 1:721 AMERICAN AVE STE 501
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-5071
Practice Address - Country:US
Practice Address - Phone:262-928-7528
Practice Address - Fax:262-928-5096
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2023-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI523332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI01175-0118Medicare PIN