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General NPI Number Information
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NPI Number | 1164611497
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Entity Type | Organization
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Legal Business Name | JOAN T. HARNEY GNADT, MD, SC
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 13133 N PORT WASHINGTON RD SUITE 11
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City | MEQUON
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State | WI
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Zip | 53097
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Country | US
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Telephone | 262-243-6000
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Fax | 262-243-6007
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Provider Business Mailing Address
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Address Line | 13133 N PORT WASHINGTON RD SUITE 11
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City | MEQUON
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State | WI
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Zip | 53097
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Country | US
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Telephone | 262-243-6000
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Fax | 262-243-6007
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOAN T GNADT
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Credential | MD
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Telephone | 262-243-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 28835
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License Number State | WI
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