Individual provider · Type 1 NPI

Matthew Joseph Baucom, RPSGT

Electroneurodiagnostic Specialist/Technologist · Mequon, WI

NPI number 1851488720 Active

Practice location

11649 N Port Washington Rd, Ste 109
Mequon, WI 53092

Fax (262) 241-8047

Mailing address

1580 W Portview Dr, Apt #2
Port Washington, WI 53074

Specialties and licenses

TaxonomyCodeLicense
Electroneurodiagnostic Specialist/Technologist Primary 246ZE0600XNone listed

Electroneurodiagnostic Specialist/Technologist: Definition to come...

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About NPI 1851488720

Matthew Joseph Baucom, RPSGT's National Provider Identifier is 1851488720, issued on Oct 10, 2006. The primary taxonomy on file is Electroneurodiagnostic Specialist/Technologist (246ZE0600X), and the practice location is in Mequon, WI. The record was last updated on Jul 8, 2007.