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Individual

DONALD R GORE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2920 SUPERIOR AVE, SHEBOYGAN, WI 53081-1944
(920) 458-3791
(920) 458-3783
Mailing address
2920 SUPERIOR AVE, SHEBOYGAN, WI 53081-1944
(920) 458-3791
(920) 458-3783

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
14045
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31199200
WI
Enumeration date
10/07/2005
Last updated
07/08/2007
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