Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 5101019449 | MI |
N | 111NI0900X | Internist | 5101019449 | MI |
Y | 207RG0100X | Gastroenterologist | 5101019449 | MI |
NPI | 1023303641 |
---|---|
Provider Name | Dr. Sarah Anne Wasserman |
First Address | Grand Blanc, MI 48439-8065 |
Second Address | Portage, MI 49024-7430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2011 |
Last Update Date | 25/09/2020 |