Provider Demographics
NPI:1538112289
Name:NORMAN, SHARNIECIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARNIECIA
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1350 S SUNNY SLOPE RD
Mailing Address - Street 2:SUNNYSLOPE PRIMARY CARE CLINIC
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-7025
Mailing Address - Country:US
Mailing Address - Phone:414-805-9600
Mailing Address - Fax:414-805-9659
Practice Address - Street 1:1350 S SUNNY SLOPE RD
Practice Address - Street 2:SUNNYSLOPE PRIMARY CARE CLINIC
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-7025
Practice Address - Country:US
Practice Address - Phone:414-805-9600
Practice Address - Fax:414-805-9659
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI46451207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
039906263KOtherHUMANA
WI73601 2158Medicare PIN
WI024968086Medicare PIN
039906263KOtherHUMANA