Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 45697 | WI |
N | 207PP0204X | Pediatric Emergency Physician | 48531 | MN |
Y | 2080P0204X | Pediatric Emergency Doctor | 45697 | WI |
N | 2080P0204X | Pediatric Emergency Doctor | 48531 | MN |
NPI | 1346291010 |
---|---|
Provider Name | Christopher D Spahr |
First Address | Milwaukee, WI 53226-4874 |
Second Address | Milwaukee, WI 53226-4874 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 21/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1346291010 | (05) | WI |
553650200 | (05) | MN |
H97736 | (02) |