Provider Demographics
NPI:1184697187
Name:MAKHIJA, SARITA (MD)
Entity type:Individual
Prefix:
First Name:SARITA
Middle Name:
Last Name:MAKHIJA
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:N14W23900 STONE RIDGE DR
Mailing Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES INC
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1135
Mailing Address - Country:US
Mailing Address - Phone:262-574-8000
Mailing Address - Fax:
Practice Address - Street 1:N14W23900 STONE RIDGE DR
Practice Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES INC
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1135
Practice Address - Country:US
Practice Address - Phone:262-574-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI270302083X0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30677300Medicaid
WI30677300Medicaid
683750063Medicare PIN