Individual
DR. ANNA MARIA MYKLEBUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
W8919 RIPLEY RD, P.O. 629, CAMBRIDGE, WI 53523-9011
(608) 423-7400
(608) 423-7400
Mailing address
W8919 RIPLEY RD, P.O. 629, CAMBRIDGE, WI 53523-9011
(608) 423-7400
(608) 423-7400
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
34650-020
WI
2085R0202X
Diagnostic Radiology Physician
38149
IA
2085R0202X
Diagnostic Radiology Physician
51515
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300088211
RAILROAD MEDICARE
WI
05
—
3195200
—
WI
01
—
391128616RU
JOHN DEERE HEALTH PLAN
WI
01
—
4873
DEAN HEALTH INSURANCE
WI
Enumeration date
07/01/2006
Last updated
02/28/2015
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