Individual
HOWARD J GOLLUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
N112 W17975 MEQUON ROAD, MEQUON, WI 53022
(262) 532-7600
(262) 532-7602
Mailing address
3003 W GOOD HOPE ROAD, MILWAUKEE, WI 53209
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24163
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30413900
—
WI
Enumeration date
07/05/2006
Last updated
01/25/2011
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