Provider Demographics
NPI:1194258756
Name:MAHASWARAN, HARIPRASATH (MD)
Entity type:Individual
Prefix:DR
First Name:HARIPRASATH
Middle Name:
Last Name:MAHASWARAN
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 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0001
Mailing Address - Country:US
Mailing Address - Phone:715-838-5222
Mailing Address - Fax:
Practice Address - Street 1:13025 8TH STREET
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:WI
Practice Address - Zip Code:54758-7636
Practice Address - Country:US
Practice Address - Phone:715-926-4858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2024-11-22
Deactivation Date:2017-11-17
Deactivation Code:
Reactivation Date:2017-11-29
Provider Licenses
StateLicense IDTaxonomies
WI73338-20207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine