Individual
THERESE J GESTELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3200 PLEASANT VALLEY RD, WEST BEND, WI 53095-9274
(262) 836-7300
(262) 836-7301
Mailing address
3200 PLEASANT VALLEY RD, WEST BEND, WI 53095-9274
(262) 836-7300
(262) 836-7301
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
40936-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649227950
—
WI
05
—
32553200
—
WI
01
—
930074906
MEDICARE RAILROAD
WI
01
—
930074935
MEDICARE RAILROAD
WI
Enumeration date
05/30/2006
Last updated
09/02/2020
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