Provider Demographics
NPI:1427384486
Name:PRATT, SARAH J (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:J
Last Name:PRATT
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 1:3062 E NEWPORT CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2910
Mailing Address - Country:US
Mailing Address - Phone:414-332-0969
Mailing Address - Fax:
Practice Address - Street 1:3062 E NEWPORT CT
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-2910
Practice Address - Country:US
Practice Address - Phone:414-332-0969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22499208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIB55833Medicare UPIN
WI004873305Medicare PIN