Provider Demographics
NPI:1548385743
Name:MASLACH-HUBBARD, ANNA (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:MASLACH-HUBBARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 PLEASANT PL
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-0999
Mailing Address - Country:US
Mailing Address - Phone:734-332-8903
Mailing Address - Fax:
Practice Address - Street 1:105 PLEASANT PL
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-3921
Practice Address - Country:US
Practice Address - Phone:734-332-8903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088752208000000X, 390200000X
UT7347043-12052080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program