Individual
DR. GERALD A WANKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 PROFESSIONAL DR, ALTON, IL 62002-5067
(618) 465-2020
(618) 465-2046
Mailing address
320 BROOKES DR, SUITE 111, HAZELWOOD, MO 63042-2736
(314) 726-5669
(314) 726-5109
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036079558
IL
Other
Enumeration date
05/27/2005
Last updated
06/29/2012
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