Individual
DR. MARK GERHARD EBERHAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1532 E BELLEVIEW PL, MILWAUKEE, WI 53211-3956
(414) 220-9990
(414) 221-0001
Mailing address
1532 E BELLEVIEW PL, MILWAUKEE, WI 53211-3956
(414) 220-9990
(414) 221-0001
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1814
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39107700
—
WI
Enumeration date
10/28/2005
Last updated
07/23/2019
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