Healthcare Provider Details

I. General information

NPI: 1750871745
Provider Name (Legal Business Name): SARA SALEH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BARRY DR
LAPEER MI
48446-3661
US

IV. Provider business mailing address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 810-667-7304
  • Fax: 810-667-7348
Mailing address:
  • Phone: 414-805-8710
  • Fax: 414-955-0115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number4301511632
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number85192
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: