Campbell, Matthew

Campbell, Matthew is an individual health care provider with primary practice located at 2300 Western Ave , Manitowoc WI 54220-3712. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Campbell, Matthew can be contacted via phone (920) 320-3165.

Contact Information

Primary practice address
2300 Western Ave Manitowoc WI 54220-3712
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 51519 Wisconsin

Profile Details

NPI number 1821030859
LBN Legal business name Campbell, Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Feb 1st, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821030859 NPPES
Wisconsin Other 1821030859 BCBS
Wisconsin Other P00688641 BCBS
Wisconsin MEDICAID 208600000X BCBS

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