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Organization

ADVANCED INTERVENTIONS, SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GREGG MICHAEL GAYLORD MD (DIRECTOR)
(920) 946-2505
Entity
Organization

Contact information

Practice address
805 N MAYFAIR RD, ADVANCED INTERVENTIONS VASCARE, WAUWATOSA, WI 53226-4241
(414) 988-6773
(414) 988-6779
Mailing address
4131 W LOOMIS RD, STE 210, GREENFIELD, WI 53221-2057
(920) 946-2505

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
WI

Other

Enumeration date
01/19/2011
Last updated
12/06/2011
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