Healthcare Provider Details

I. General information

NPI: 1487708988
Provider Name (Legal Business Name): WALTER BRUMMUND M.D.,PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N MAYFAIR RD SUITE 220
WAUWATOSA WI
53226-1409
US

IV. Provider business mailing address

1701 WEDGEWOOD DR W
ELM GROVE WI
53122-1056
US

V. Phone/Fax

Practice location:
  • Phone: 414-475-9101
  • Fax: 414-475-9203
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: