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Individual

DR. SHERAN S MAHATME

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
9200 W WISCONSIN AVE, INFECTIOUS DISEASE, MILWAUKEE, WI 53226-3522
(414) 805-6444
(414) 805-6702
Mailing address
9200 W WISCONSIN AVE, INFECTIOUS DISEASE, MILWAUKEE, WI 53226-3522
(414) 805-6444
(414) 805-6702

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102201736
VA
207RI0200X
Infectious Disease Physician
0102201736
VA
207RI0200X
Infectious Disease Physician
2009-1453
NC
207RI0200X
Infectious Disease Physician
Primary
65183
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
-032
TRICARE/CHAMPUS
VA
05
010188075
VA
01
01553
BC/BS
NC
01
10003501
SENTARA / OPTIMA INFECTIOUS DISEASE
VA
01
10003793
SENTARA/INF DIS PCP
VA
05
1396711297
WI
01
154EE
BC/BS NC
NC
01
186800
ANTHEM
VA
05
5901553
NC
01
9140289
UHC/MAMSI
VA
01
PAR
CIGNA
VA
Enumeration date
02/28/2006
Last updated
03/24/2016
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