Individual
DR. GEORGE E GILMORE IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
818 FOREST LN, WATERFORD, WI 53185-4585
(262) 514-8199
Mailing address
818 FOREST LN, WATERFORD, WI 53185-4585
(262) 514-8199
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
41548-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34098900
—
WI
Enumeration date
12/19/2005
Last updated
12/28/2021
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