Bong, Matthew Robert
Bong, Matthew Robert is an individual health care provider with primary practice located at N15W28300 Golf Rd , Pewaukee WI 53072-4800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Bong, Matthew Robert can be contacted via phone (262) 544-5311.Contact Information
Primary practice address
N15W28300 Golf Rd
Pewaukee WI 53072-4800
Phone: (262) 544-5311
Fax: (262) 544-6820
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 49242 | Wisconsin |
Profile Details
| NPI number | 1588627368 |
|---|---|
| LBN Legal business name | Bong, Matthew Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2006 |
| Last updated | Mar 7th, 2023 - about 2 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 | 1588627368 | NPPES |
| Wisconsin | MEDICAID | 1588627368 | |
| Wisconsin | MEDICAID | 34873700 |
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