Individual
GARETH HATTERSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3666
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
71815
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2017
Last updated
05/18/2020
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