Provider Demographics
NPI:1447238241
Name:UPPIN, ANITA A (MD)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:A
Last Name:UPPIN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:LAHEY CLINIC MEDICAL CTR
Mailing Address - Street 2:41 MALL ROAD
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8170
Mailing Address - Fax:781-744-5247
Practice Address - Street 1:LAHEY CLINIC MEDICAL CTR
Practice Address - Street 2:41 MALL ROAD
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8170
Practice Address - Fax:781-744-5247
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2010-05-18
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Provider Licenses
StateLicense IDTaxonomies
MA2164762085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2005085Medicaid
H84508Medicare UPIN
MAA35279Medicare PIN