Individual
KEVIN GONIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11430 N PORT WASHINGTON RD, MEQUON, WI 53092-3414
(262) 518-1900
Mailing address
10609 N RIVERLAKE CT, MEQUON, WI 53092-4865
(414) 531-6048
(262) 643-4791
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23770
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30475300
—
WI
Enumeration date
07/10/2006
Last updated
04/06/2022
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