Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 32071 | WI |
NPI | 1033142203 |
---|---|
Provider Name | Bruce T Faure |
First Address | Milwaukee, WI 53209 |
Second Address | Milwaukee, WI 53209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 01/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31694700 | (05) | WI |
E86962 | (02) | |
P00774642 | RR MEDICARE (01) | WI |