IndividualActive
Irina Goncharova, MD
NPI 1104857465 · Vascular Surgery Physician · Milwaukee, WI
Provider details
- NPI number
- 1104857465
- Entity type
- Individual
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- 03611663 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
2801 W Kinnickinnic River Pkwy
Suite 485
Milwaukee, WI 53215-3669
Phone: (414) 646-8900
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 735044
Chicago, IL 60673-5044
Registry dates
- Enumerated
- 2006-07-05
- Last updated
- 2023-12-27
- Certified
- 2023-12-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.