Provider Demographics
NPI:1104260702
Name:ANAYA, YOHUALLI BALDERAS-MEDINA (MD)
Entity type:Individual
Prefix:DR
First Name:YOHUALLI
Middle Name:BALDERAS-MEDINA
Last Name:ANAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YOHUALLI
Other - Middle Name:
Other - Last Name:BALDERAS-MEDINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1102 S PARK ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1708
Practice Address - Country:US
Practice Address - Phone:608-263-3111
Practice Address - Fax:608-263-6663
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI77415207Q00000X
CAA135425207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine