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General NPI Number Information
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NPI Number | 1023080447
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Entity Type | Individual
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Provider Name | JENNIFER DOUBLESTEIN SANDY D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 1445 SHELDON RD STE 201
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City | GRAND HAVEN
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State | MI
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Zip | 49417-2479
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Country | US
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Telephone | 616-847-5489
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Fax | 616-847-5479
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Provider Business Mailing Address
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Address Line | 1445 SHELDON RD STE 201
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City | GRAND HAVEN
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State | MI
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Zip | 49417-2479
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Country | US
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Telephone | 616-847-5489
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Fax | 616-847-5479
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0102201734
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101015469
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License Number State | MI
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