Provider Demographics
NPI:1699726356
Name:TUINSTRA, DAVID A (PA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:TUINSTRA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 W KILBOURN AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-1325
Mailing Address - Country:US
Mailing Address - Phone:414-765-0010
Mailing Address - Fax:414-276-1758
Practice Address - Street 1:1218 W KILBOURN AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-5323
Practice Address - Country:US
Practice Address - Phone:414-765-0010
Practice Address - Fax:414-276-1758
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI658363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
029906261BOtherHUMANA
WI42933100Medicaid
WI42933100Medicaid
029906261BOtherHUMANA
WI019940709Medicare PIN
0036Q73601Medicare ID - Type Unspecified