Provider Demographics
NPI:1700306974
Name:FUHS, AVERILL (DO)
Entity Type:Individual
Prefix:DR
First Name:AVERILL
Middle Name:
Last Name:FUHS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 HWY 71 S
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360
Mailing Address - Country:US
Mailing Address - Phone:712-336-3750
Mailing Address - Fax:712-336-3730
Practice Address - Street 1:2301 HIGHWAY 71 STE C
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1184
Practice Address - Country:US
Practice Address - Phone:712-336-3750
Practice Address - Fax:712-336-3730
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-10920207Q00000X
IADO05279207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine