Provider Demographics
NPI:1952358228
Name:DONIPARTHI, ANILKUMAR (MD)
Entity type:Individual
Prefix:MR
First Name:ANILKUMAR
Middle Name:
Last Name:DONIPARTHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 N 109TH ST
Mailing Address - Street 2:STE 1
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3754
Mailing Address - Country:US
Mailing Address - Phone:414-777-1811
Mailing Address - Fax:414-777-1812
Practice Address - Street 1:830 N 109TH ST
Practice Address - Street 2:STE 1
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3754
Practice Address - Country:US
Practice Address - Phone:414-777-1811
Practice Address - Fax:414-777-1812
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI38316207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32296000Medicaid
WI000168925Medicare ID - Type Unspecified
WIG41851Medicare UPIN