Individual
DR. JOHN GILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
Mailing address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
45328
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34809100
—
WI
Enumeration date
05/15/2006
Last updated
07/26/2007
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