Timothy A Fagre MD

NPI 1093821829 - Family Medicine - 207Q00000X

NPI Details
NPI 1093821829
Gender Male
Enumeration Date 08/22/2006
Last Updated 07/09/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1565 ALLOUEZ AVE
GREEN BAY WI, 54311, US
Phone (920) 468-2400
Fax (920) 468-2428
Business Location
3301 W FOREST HOME AVE
MILWAUKEE WI, 53215-2843, US
Phone (414) 647-6326
Fax (414) 671-8860
Toxanomy
Taxonomy Code 207Q00000X
License State Wisconsin
License Number 39660
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According to our database, Dr. Timothy A Fagre MD NPI is 1093821829, taxonomy code is 207Q00000X and license number is 39660, license state is located at Wisconsin. Timothy A Fagre MD physically located at 1565 Allouez Ave, Green Bay WI, 54311. NPI Number Timothy A Fagre MD has the Individual type.

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1093821829 NPI number is provided on an as is basis without warranty of any kind. 1093821829 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy A Fagre MD are for informational purposes only.