Healthcare Provider Details

I. General information

NPI: 1952015489
Provider Name (Legal Business Name): MICHELE MARIE SAWYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2023
Last Update Date: 01/10/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E. BIDDLE STREET
JACKSON MI
49203-4920
US

IV. Provider business mailing address

PO BOX 6159
JACKSON MI
49204-6159
US

V. Phone/Fax

Practice location:
  • Phone: 517-783-3434
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: