Gaylord, Gregg Michael

Gaylord, Gregg Michael is an sole proprietor health care provider with primary practice located at 805 N Mayfair Rd , Wauwatosa WI 53226-4241. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Gaylord, Gregg Michael can be contacted via phone (414) 988-6773.

Contact Information

Primary practice address
805 N Mayfair Rd Wauwatosa WI 53226-4241
Phone: (414) 988-6773
Fax: (414) 301-7253
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 38440 Wisconsin
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 38440 Wisconsin

Profile Details

NPI number 1396890372
LBN Legal business name Gaylord, Gregg Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 23rd, 2007
Last updated Feb 6th, 2017 - about 7 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 1396890372 NPPES
Wisconsin MEDICAID 32301700

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