Basic Information
Provider Information
NPI: 1629491113
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HIRSCHMAN
FirstName: SARAH
MiddleName: ELIZABETH
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3272
Address2:  
City: SAGINAW
State: MI
PostalCode: 486053272
CountryCode: US
TelephoneNumber: 9897971400
FaxNumber: 9897974077
Practice Location
Address1: 1523 S MISSION ST
Address2:  
City: MT PLEASANT
State: MI
PostalCode: 488584230
CountryCode: US
TelephoneNumber: 9897731166
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/04/2014
LastUpdateDate: 09/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X5601006928MIY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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