Provider Demographics
NPI:1679738124
Name:FUHRER, JAMIE (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:FUHRER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 W LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3691
Mailing Address - Country:US
Mailing Address - Phone:814-454-1085
Mailing Address - Fax:814-240-3976
Practice Address - Street 1:3250 W LAKE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3691
Practice Address - Country:US
Practice Address - Phone:814-454-1085
Practice Address - Fax:814-240-3976
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT0125392084P0800X
PAOS0150492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102728988 0001Medicaid
PA102728988 0001Medicaid