Burris, Robert Wayne
Burris, Robert Wayne is an sole proprietor health care provider with primary practice located at 8055 N 65Th St , Brown Deer WI 53223-3408. He recently has only one registered license in Other Service Providers / Driver, which is considered as his primary health care specialty. Burris, Robert Wayne can be contacted via phone (414) 881-1858.Contact Information
Primary practice address
8055 N 65Th St
Brown Deer WI 53223-3408
Phone: (414) 881-1858
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Driver | 172A00000X | B620-7797-3121-06 | Wisconsin |
Profile Details
| NPI number | 1760154389 |
|---|---|
| LBN Legal business name | Burris, Robert Wayne |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 1st, 2021 |
| Last updated | Oct 1st, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760154389 | NPPES |
| Wisconsin | MEDICAID | 100008887 |
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