Provider Demographics
NPI:1447271309
Name:PRPA, BRANKO (MD)
Entity type:Individual
Prefix:
First Name:BRANKO
Middle Name:
Last Name:PRPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6308 8TH AVE
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53143-5031
Mailing Address - Country:US
Mailing Address - Phone:262-656-2600
Mailing Address - Fax:262-656-2634
Practice Address - Street 1:6308 8TH AVE
Practice Address - Street 2:SUITE 1020
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53143-5031
Practice Address - Country:US
Practice Address - Phone:262-656-2600
Practice Address - Fax:262-656-2634
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44808-020207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1447271309Medicaid
G38281Medicare UPIN
WI322500126Medicare PIN