Provider Demographics
NPI:1518057512
Name:JEFFREYS, SANA (MD)
Entity Type:Individual
Prefix:
First Name:SANA
Middle Name:
Last Name:JEFFREYS
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 1:3003 W GOOD HOPE RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2042
Mailing Address - Country:US
Mailing Address - Phone:414-352-3100
Mailing Address - Fax:
Practice Address - Street 1:400 SUGAR CAMP CIR STE 200
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:OH
Practice Address - Zip Code:45409-1981
Practice Address - Country:US
Practice Address - Phone:937-276-8320
Practice Address - Fax:937-276-8325
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD7053207RH0003X
MI4301075967207RH0003X
WI43574-020207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100038598Medicaid
SDS101956Medicare PIN
WIK400137030Medicare PIN
SDP00448282Medicare PIN