Individual
DR. JEROME L GOTTSCHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
HOSPITAL BASED @ FROEDTERT HOSP., 9200 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53226
(414) 805-3666
Mailing address
638 N 18TH ST, PO BOX 2178, MILWAUKEE, WI 53233-2121
(414) 937-6231
(414) 933-6803
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
22688
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30432400
—
WI
Enumeration date
05/20/2006
Last updated
07/08/2007
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