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General NPI Number Information
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NPI Number | 1063233492
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Entity Type | Organization
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Legal Business Name | RA2 PC
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 81 S I 75 BUSINESS LOOP
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City | GRAYLING
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State | MI
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Zip | 49738-7405
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Country | US
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Telephone | 989-348-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 1920 STURGEON VALLEY RD E
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City | VANDERBILT
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State | MI
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Zip | 49795-9751
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Country | US
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Telephone | 912-532-9907
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Fax |
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Authorized Official
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Title or Position | EMERGENCY MEDICINE PHYSICIAN
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Name | DR. RACHEL ANNE AMSTERBURG
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Credential | DO
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Telephone | 912-532-9907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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