Provider Demographics
NPI:1568532521
Name:PARKINS, MAIDA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:MAIDA
Middle Name:ANN
Last Name:PARKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAIDA
Other - Middle Name:ANN
Other - Last Name:LUDWIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M,D
Mailing Address - Street 1:10604 N. PORT WASHINGTON RD.
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092
Mailing Address - Country:US
Mailing Address - Phone:262-242-7772
Mailing Address - Fax:262-478-0884
Practice Address - Street 1:W307 N1497 GOLF RD
Practice Address - Street 2:SUITE 200
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018
Practice Address - Country:US
Practice Address - Phone:262-303-4876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49928020208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery