Provider Demographics
NPI:1396188348
Name:RAMADANI, SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:RAMADANI
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 1:9555 76TH STREET
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-1984
Mailing Address - Country:US
Mailing Address - Phone:262-577-8400
Mailing Address - Fax:262-577-8476
Practice Address - Street 1:10256 OLD GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-2814
Practice Address - Country:US
Practice Address - Phone:262-551-4210
Practice Address - Fax:262-551-4942
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI64167-20207QB0002X, 207Q00000X
IN01077349A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400462559OtherMEDICARE
WIK400462559OtherMEDICARE