Basic Information
| Provider Information | |||||||||
| NPI: | 1225440373 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDREWS | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | AKRE | ||||||||
| OtherFirstName: | SARA | ||||||||
| OtherMiddleName: | A | ||||||||
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| OtherCredential: | DO | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1675 LEAHY ST | ||||||||
| Address2: | SUITE 315A | ||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494425500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317281751 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1675 LEAHY ST | ||||||||
| Address2: | SUITE 311A | ||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494425500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317285600 | ||||||||
| FaxNumber: | 2317284691 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2014 | ||||||||
| LastUpdateDate: | 04/15/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 5101020926 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | 5101020926 | MI | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.