Provider Demographics
NPI:1902914401
Name:SAUER, PAUL A (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:SAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-7614
Mailing Address - Country:US
Mailing Address - Phone:262-767-6020
Mailing Address - Fax:
Practice Address - Street 1:709 SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105
Practice Address - Country:US
Practice Address - Phone:262-767-6020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36717-020207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
11064OtherDEAN HEALTH PLAN - HMD
WI32135400Medicaid
IL036088994Medicaid
IL0739010008Medicare NSC
IL0739010001Medicare NSC
ILR03736Medicare PIN
IL0739010005Medicare NSC
F90343Medicare UPIN
IL0739010011Medicare NSC
IL036088994Medicaid
ILR03737Medicare PIN
WI000054275Medicare ID - Type Unspecified
IL370830Medicare PIN
IL208887Medicare PIN