Individual
DR. SOPHOS GEORGIO GEROULIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-5000
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
49566-020
WI
2084N0600X
Clinical Neurophysiology Physician
49566-020
WI
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
49566-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295820637
—
WI
01
—
27-5013474
NEUROQUEST, LLC
WI
Enumeration date
10/03/2006
Last updated
12/28/2017
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