Provider Demographics
NPI:1952593725
Name:FREA, ANNE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARIE
Last Name:FREA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:GOTSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:615 W MORELAND BLVD
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-2462
Mailing Address - Country:US
Mailing Address - Phone:262-896-8420
Mailing Address - Fax:262-896-8521
Practice Address - Street 1:2130 BIG BEND RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53189-7624
Practice Address - Country:US
Practice Address - Phone:262-928-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI53033-020207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine