Provider Demographics
NPI:1689838690
Name:HARIMAN, SARA LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LOUISE
Last Name:HARIMAN
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 1:5000 W NATIONAL AVE
Mailing Address - Street 2:DIVISION OF CARDIOVASCULAR MEDICINE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53295-0001
Mailing Address - Country:US
Mailing Address - Phone:414-805-3666
Mailing Address - Fax:414-383-8010
Practice Address - Street 1:5000 W NATIONAL AVE
Practice Address - Street 2:DIVISION OF CARDIOVASCULAR MEDICINE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:414-805-3666
Practice Address - Fax:414-383-8010
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-050964207R00000X
WI52678207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1689838690Medicaid