Provider Demographics
NPI:1396839833
Name:MILLER-GUHL, AMY LYNN (DPM)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN
Last Name:MILLER-GUHL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:20700 WATERTOWN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1800
Mailing Address - Country:US
Mailing Address - Phone:262-544-0700
Mailing Address - Fax:262-544-9017
Practice Address - Street 1:20700 WATERTOWN RD STE 200
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186
Practice Address - Country:US
Practice Address - Phone:262-544-0700
Practice Address - Fax:262-544-9017
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI850-025213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43234600Medicaid
WIP01633658OtherRAILROAD MEDICARE
WIP01633658OtherRAILROAD MEDICARE
WIU92946Medicare UPIN
WI43234600Medicaid