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Individual

MR. TIMOTHY ALLEN FEHRENBACHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
2801 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3669
(414) 649-3240
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2233

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1322
WI
363AS0400X
Surgical Physician Assistant
1322023
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41924500
WI
Enumeration date
01/26/2007
Last updated
12/01/2021
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