Individual
DR. ELIZABETH M GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF RADIATION ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-4400
(414) 805-4369
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF RADIATION ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-4400
(414) 805-4369
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
32575
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000105C
HUMANA
—
05
—
1710938519
—
WI
Enumeration date
05/15/2006
Last updated
02/01/2013
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