Provider Demographics
NPI:1194803676
Name:FUHR, WALTER A (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:A
Last Name:FUHR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2088 MILWAUKEE AVE UNIT I
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-7791
Mailing Address - Country:US
Mailing Address - Phone:262-757-4131
Mailing Address - Fax:262-757-4727
Practice Address - Street 1:2088 MILWAUKEE AVE UNIT I
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-7791
Practice Address - Country:US
Practice Address - Phone:262-757-4131
Practice Address - Fax:262-757-4727
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37614207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI68015-0049Medicare PIN
WI02120-0035Medicare PIN