Healthcare Provider Details

I. General information

NPI: 1770810079
Provider Name (Legal Business Name): YEKTA VICTORIA GADBOIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2009
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W SILVER SPRING DR STE K200
MILWAUKEE WI
53217-5052
US

IV. Provider business mailing address

500 W SILVER SPRING DR STE K200
MILWAUKEE WI
53217-5052
US

V. Phone/Fax

Practice location:
  • Phone: 414-293-3810
  • Fax:
Mailing address:
  • Phone: 414-293-3810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number51859-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: