Provider Demographics
NPI:1841241353
Name:ANTON, ANDREEA L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREEA
Middle Name:L
Last Name:ANTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANDREEA
Other - Middle Name:L
Other - Last Name:ANTONESCU-TURCU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DIVISION OF PULMONARY DISEASE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6633
Mailing Address - Fax:414-805-3859
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DIVISION OF PULMONARY DISEASE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6633
Practice Address - Fax:414-805-3859
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47838207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
039906263WOtherHUMANA
WI34632200Medicaid
WI1841241353Medicaid
WI34632200Medicaid
WI071R73601Medicare PIN