Individual
GARY J. FEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
W180N8085 TOWN HALL RD, 3 SW STE. 4, MENOMONEE FALLS, WI 53051-3518
(262) 532-6899
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
222
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42939900
—
WI
01
—
P00858750
RR MEDICARE
WI
Enumeration date
07/01/2006
Last updated
11/09/2010
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