Basic Information
Provider Information
NPI: 1457881948
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEERS
FirstName: SARAH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 520 COBB ST
Address2:  
City: CADILLAC
State: MI
PostalCode: 496012588
CountryCode: US
TelephoneNumber: 2318766527
FaxNumber: 2318766519
Practice Location
Address1: 1035 E WILCOX AVE
Address2:  
City: WHITE CLOUD
State: MI
PostalCode: 493498794
CountryCode: US
TelephoneNumber: 2316895943
FaxNumber: 2316891590
Other Information
ProviderEnumerationDate: 06/15/2017
LastUpdateDate: 10/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X4301112905MIN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X5315086636MIN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X4301500595MIY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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