Provider Demographics
NPI:1841218997
Name:SABHARWAL, PRIYA (MD)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:SABHARWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PRIYA
Other - Middle Name:
Other - Last Name:GUPTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8905 W LINCOLN AVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2468
Mailing Address - Country:US
Mailing Address - Phone:414-978-2229
Mailing Address - Fax:414-978-2279
Practice Address - Street 1:8905 W LINCOLN AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2468
Practice Address - Country:US
Practice Address - Phone:414-978-2229
Practice Address - Fax:414-978-2279
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036107765207V00000X
IN01075860A207V00000X
WI66775-20207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036107765Medicaid
WI1841218997Medicaid
IN201314360AMedicaid
IN201314360Medicaid
IN201314360Medicaid
WI1841218997Medicaid
ILL94544Medicare PIN
WIK400365828Medicare PIN
IN162520040Medicare PIN