Individual
DR. ROBERT JOSEPH GOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10945 N PORT WASHINGTON RD, SUITE 211, MEQUON, WI 53092-5078
(262) 241-8000
(262) 241-8096
Mailing address
10945 N PORT WASHINGTON RD, SUITE 211, MEQUON, WI 53092-5078
(262) 241-8000
(262) 241-8096
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
22771-020
WI
207YS0123X
Facial Plastic Surgery Physician
222771
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040004274
RRB
WI
05
—
30326800
—
WI
Enumeration date
08/18/2005
Last updated
10/30/2009
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