MEDICARE: BRANKO PRPA MD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1134460066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANKO PRPA MD LLC

Provider Business Mailing Address
First Line	:	6233 BANKERS RD
Second Line	:	SUITE 11
City	:	MOUNT PLEASANT
State	:	WI
Zip	:	53403-9700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6233 BANKERS RD
Second Line	:	SUITE 11
City	:	MOUNT PLEASANT
State	:	WI
Zip	:	53403-9700
Country	:	US
Telephone Number	:	262-456-1070
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRANKO PRPA
Credential	:	MD
Telephone Number	:	262-456-1070

Provider Enumeration Date	:	03/01/2013
Last Update Date	:	03/01/2013

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