Provider Demographics
NPI:1194851402
Name:UPPAL, ANITA S (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:S
Last Name:UPPAL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10330 MERIDIAN AVE N
Mailing Address - Street 2:#230
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9451
Mailing Address - Country:US
Mailing Address - Phone:206-524-4737
Mailing Address - Fax:206-524-4740
Practice Address - Street 1:10330 MERIDIAN AVE N
Practice Address - Street 2:#230
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9451
Practice Address - Country:US
Practice Address - Phone:206-524-4737
Practice Address - Fax:206-524-4740
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2020-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00037003207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8244725Medicaid
WA8244725Medicaid
WAG8864393Medicare PIN