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NPI Code Detail

MEDICARE: DR. MARY L ZUPANC MD

MEDICARE: DR. MARY L ZUPANC 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
12084N0400XNeurology Physician25058WI
22084N0402XNeurology with Special Qualifications in Child Neurology Physician25058-20WI

General Provider Information

NPI Number : 1861444366
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY L ZUPANC MD
Provider Business Mailing Address
First Line : 155 E WILSON ST APT 404
Second Line :
City : MADISON
State : WI
Zip : 53703-3487
Country : US
Telephone Number : 414-403-6174
Fax Number :
Provider Business Practice Location Address
First Line : 155 E WILSON ST APT 404
Second Line :
City : MADISON
State : WI
Zip : 53703-3487
Country : US
Telephone Number : 414-403-6174
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 04/09/2026

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