Healthcare Provider Details

I. General information

NPI: 1871234963
Provider Name (Legal Business Name): SARAH D BELL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH D HANNER

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LAFAYETTE AVE SE STE 4000
GRAND RAPIDS MI
49503-4692
US

IV. Provider business mailing address

200 JEFFERSON AVE SE STE 305
GRAND RAPIDS MI
49503-4502
US

V. Phone/Fax

Practice location:
  • Phone: 616-685-6922
  • Fax:
Mailing address:
  • Phone: 616-685-6741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5151015488
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: