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NPI Code Detail

MEDICARE: DR. PAULA R HUBERT MD

MEDICARE: DR. PAULA R HUBERT MD
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
1207V00000XObstetrics & Gynecology Physician63368-20WI
2207V00000XObstetrics & Gynecology Physician4301093114MI

General Provider Information

NPI Number : 1487647087
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAULA R HUBERT MD
Provider Business Mailing Address
First Line : 1531 S MADISON ST
Second Line : 3RD FLOOR
City : APPLETON
State : WI
Zip : 54915-1800
Country : US
Telephone Number : 920-730-4413
Fax Number :
Provider Business Practice Location Address
First Line : 1531 S MADISON ST
Second Line : 3RD FLOOR
City : APPLETON
State : WI
Zip : 54915-1800
Country : US
Telephone Number : 920-730-4413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 01/02/2015

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