Provider Demographics
NPI:1487647087
Name:HUBERT, PAULA R (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:R
Last Name:HUBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAULA
Other - Middle Name:R
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1531 S MADISON ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-1800
Mailing Address - Country:US
Mailing Address - Phone:920-730-4413
Mailing Address - Fax:
Practice Address - Street 1:1531 S MADISON ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-1800
Practice Address - Country:US
Practice Address - Phone:920-730-4413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63368-20207V00000X
MI4301093114207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology