Individual
DR. ISAAC MELGUIZO-GAVILANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY STE 925, MILWAUKEE, WI 53215-3689
(414) 384-5111
Mailing address
2801 W KINNICKINNIC RIVER PKWY STE 925, MILWAUKEE, WI 53215-3689
(414) 384-5111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A102171
CA
2084N0400X
Neurology Physician
Primary
68347-20
WI
2084N0400X
Neurology Physician
P0638
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710157078
—
WI
05
—
290780001
—
TX
Enumeration date
03/03/2008
Last updated
11/23/2021
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