Healthcare Provider Details
I. General information
NPI: 1346291010
Provider Name (Legal Business Name): CHRISTOPHER D SPAHR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/15/2006
Last Update Date: 10/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9000 W WISCONSIN AVE PEDIATRIC EMERGENCY MEDICINE
MILWAUKEE WI
53226-4874
US
IV. Provider business mailing address
9000 W WISCONSIN AVE PEDIATRIC EMERGENCY MEDICINE
MILWAUKEE WI
53226-4874
US
V. Phone/Fax
- Phone: 414-266-2625
- Fax: 414-266-2635
- Phone: 414-266-2625
- Fax: 414-266-2635
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0204X |
| Taxonomy | Pediatric Emergency Medicine (Pediatrics) Physician |
| License Number | 48531 |
| License Number State | MN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PP0204X |
| Taxonomy | Pediatric Emergency Medicine (Emergency Medicine) Physician |
| License Number | 48531 |
| License Number State | MN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PP0204X |
| Taxonomy | Pediatric Emergency Medicine (Emergency Medicine) Physician |
| License Number | 45697 |
| License Number State | WI |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0204X |
| Taxonomy | Pediatric Emergency Medicine (Pediatrics) Physician |
| License Number | 45697 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: