Provider Demographics
NPI:1255311023
Name:FUERSTE, FREDERICK HUNTER (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:HUNTER
Last Name:FUERSTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:F
Other - Middle Name:HUNTER
Other - Last Name:FUERSTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:130 S BOOTH ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-7203
Mailing Address - Country:US
Mailing Address - Phone:563-583-7768
Mailing Address - Fax:
Practice Address - Street 1:2140 JFK RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-3883
Practice Address - Country:US
Practice Address - Phone:563-582-0769
Practice Address - Fax:563-582-5772
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA25414207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31479700Medicaid
IA0037168Medicaid
WI31479700Medicaid
D89628Medicare UPIN