Provider Demographics
NPI:1578660726
Name:FUCHS, ROBERT CARL (RN)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CARL
Last Name:FUCHS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 N SUMMIT AVE
Mailing Address - Street 2:APT 110
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1236
Mailing Address - Country:US
Mailing Address - Phone:414-347-0239
Mailing Address - Fax:
Practice Address - Street 1:2260 N SUMMIT AVE
Practice Address - Street 2:APT 110
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-1236
Practice Address - Country:US
Practice Address - Phone:414-347-0239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI73868030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39917100Medicaid