Provider Demographics
NPI:1720015571
Name:BUBLIK-ANDERSON, ANITA KAYE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:KAYE
Last Name:BUBLIK-ANDERSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2720 PLAZA DR
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4158
Mailing Address - Country:US
Mailing Address - Phone:715-847-2475
Mailing Address - Fax:715-843-1482
Practice Address - Street 1:2720 PLAZA DR
Practice Address - Street 2:SUITE 2100
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4158
Practice Address - Country:US
Practice Address - Phone:715-847-2475
Practice Address - Fax:715-843-1482
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI53016-20207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH56612Medicare UPIN