Provider Demographics
NPI:1841230208
Name:FUCHS, MATTHIAS A (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHIAS
Middle Name:A
Last Name:FUCHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 S WEBSTER AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-3505
Mailing Address - Country:US
Mailing Address - Phone:920-433-3640
Mailing Address - Fax:920-433-3716
Practice Address - Street 1:744 S WEBSTER AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-3505
Practice Address - Country:US
Practice Address - Phone:920-433-3640
Practice Address - Fax:920-433-3716
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19777-20207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30287600Medicaid
B52934Medicare UPIN
WI100200061Medicare Oscar/Certification
WI30287600Medicaid
MIP00278216Medicare Oscar/Certification
WIWI1119010Medicare Oscar/Certification
WI000600215Medicare Oscar/Certification