Healthcare Provider Details

I. General information

NPI: 1548293574
Provider Name (Legal Business Name): GARY LOHAUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GERHARD LOHAUS MD

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N143W6515 PIONEER RD
CEDARBURG WI
53012-2705
US

IV. Provider business mailing address

N143W6515 PIONEER RD
CEDARBURG WI
53012-2705
US

V. Phone/Fax

Practice location:
  • Phone: 262-377-6933
  • Fax:
Mailing address:
  • Phone: 262-377-6933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number20262
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: