Demattia Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

45995 Issued in WI

Legal business name

DEMATTIA MEDICAL GROUP, LLC

Practice address

5500 W Vliet St
Milwaukee, WI 53208-2120

Phone

(414) 431-8536

Fax

(414) 434-2049

NPI assigned

Jul 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Laure Grace Demattia, D.O.

Title

President

Phone

(414) 431-8536

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1285834994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 W VLIET ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532082120",
            "telephone_number": "414-431-8536",
            "fax_number": "414-434-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 W VLIET ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532082120",
            "telephone_number": "414-431-8536",
            "fax_number": "414-434-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMATTIA MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "DEMATTIA",
        "authorized_official_first_name": "LAURE",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-431-8536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "45995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Demara
• Christopher Matthew Demarco, DPT
• Leah D. Demares, APNP
• Barbara L. Demaster, PH.D.
• Linsey Demaster
• Ann Dembicky, OTR
• James Brian Dembowiak, R.PH.
• Kerry Jean Demby, O.T.R.
• Carley Demchuk, MD
• Megan Demerit, NURSE PRACTITIONER

• Family Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.