Individual
MARC GUNDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1155 N MAYFAIR RD, MILWAUKEE, WI 53226-3462
(414) 955-5990
(414) 955-6282
Mailing address
1155 N MAYFAIR RD, MILWAUKEE, WI 53226-3462
(414) 955-5990
(414) 955-6282
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2017014153
MO
2084P0800X
Psychiatry Physician
Primary
62813-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194067561
—
WI
Enumeration date
03/22/2013
Last updated
06/16/2020
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