Individual
DR. GREGG MICHAEL GAYLORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
805 N MAYFAIR RD, WAUWATOSA, WI 53226-4241
(414) 988-6773
(414) 301-7253
Mailing address
805 N MAYFAIR RD, WAUWATOSA, WI 53226-4241
(414) 988-6773
(414) 301-7253
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
38440
WI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
38440
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32301700
—
WI
Enumeration date
01/23/2007
Last updated
02/06/2017
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