Healthcare Provider Details

I. General information

NPI: 1245717727
Provider Name (Legal Business Name): VALERIE MARIE TORRES MATIAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4931 S 27TH ST STE 200
GREENFIELD WI
53221-2653
US

IV. Provider business mailing address

4931 S 27TH ST STE 200
GREENFIELD WI
53221-2653
US

V. Phone/Fax

Practice location:
  • Phone: 414-546-3400
  • Fax: 414-546-3500
Mailing address:
  • Phone: 414-546-3400
  • Fax: 414-546-3500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number87725-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: