Individual
GREGORY REISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 303-8700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27306-020
WI
207RC0000X
Cardiovascular Disease Physician
Primary
27306-020
WI
207UN0901X
Nuclear Cardiology Physician
27306-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30784200
—
WI
Enumeration date
07/20/2006
Last updated
10/16/2023
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