Healthcare Provider Details

I. General information

NPI: 1558132886
Provider Name (Legal Business Name): DR W FUHR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2088 MILWAUKEE AVE STE 1
BURLINGTON WI
53105-7790
US

IV. Provider business mailing address

S75W13863 BLUHM CT
MUSKEGO WI
53150-8110
US

V. Phone/Fax

Practice location:
  • Phone: 262-757-4131
  • Fax: 262-757-4727
Mailing address:
  • Phone: 414-840-6610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. WALTER A FUHR
Title or Position: FAMILY PHYSICIAN
Credential: MD
Phone: 414-840-6610