Healthcare Provider Details
I. General information
NPI: 1063861706
Provider Name (Legal Business Name): ANUPAMA T JOSEPH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/03/2016
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 HIGHLAND AVE
MADISON WI
53792-1447
US
IV. Provider business mailing address
7974 UW HEALTH CT
MIDDLETON WI
53562-5531
US
V. Phone/Fax
- Phone: 608-263-1530
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 71356 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207UN0901X |
| Taxonomy | Nuclear Cardiology Physician |
| License Number | 71356-20 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: