Gollup, Howard J
Gollup, Howard J is an individual health care provider with primary practice located at N112 W17975 Mequon Road , Mequon WI 53022. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Gollup, Howard J can be contacted via phone (262) 532-7600.Contact Information
Primary practice address
N112 W17975 Mequon Road
Mequon WI 53022
Phone: (262) 532-7600
Fax: (262) 532-7602
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 24163 | Wisconsin |
Profile Details
| NPI number | 1588695985 |
|---|---|
| LBN Legal business name | Gollup, Howard J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Jan 25th, 2011 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588695985 | NPPES |
| Wisconsin | MEDICAID | 30413900 |
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