Provider Demographics
NPI:1558307744
Name:HUPPLER, ANNA R (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:R
Last Name:HUPPLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 GLENVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-3011
Mailing Address - Country:US
Mailing Address - Phone:608-354-2537
Mailing Address - Fax:
Practice Address - Street 1:999 N 92ND ST
Practice Address - Street 2:SUITE C450
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-4875
Practice Address - Country:US
Practice Address - Phone:414-337-7070
Practice Address - Fax:414-337-7093
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD437007208000000X
WI51358-202080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1558307744Medicaid
WIK400146291Medicare PIN