Individual
CORY THOMAS GANSHERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-3548
(414) 384-2000
Mailing address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
71460
WI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
71460
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2017
Last updated
07/06/2021
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