Healthcare Provider Details

I. General information

NPI: 1932497658
Provider Name (Legal Business Name): THUYANH CULVER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 N 87TH ST
MILWAUKEE WI
53226-3586
US

IV. Provider business mailing address

840 N 87TH ST
WAUWATOSA WI
53226-3586
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-5550
  • Fax: 920-451-5143
Mailing address:
  • Phone: 920-451-5000
  • Fax: 920-451-5143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number62400-21
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number62400
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number62400
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: