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General NPI Number Information
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NPI Number | 1306557640
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Entity Type | Individual
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Provider Name | RACHEL DIANE SATHER GERLEMAN PA
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Gender | Female
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Dates
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Enumeration Date | 12/07/2022
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 100 CHERRY ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4526
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Country | US
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Telephone | 616-965-8209
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Fax |
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Provider Business Mailing Address
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Address Line | 3649 JOLLY OAK RD UNIT B1109
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City | OKEMOS
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State | MI
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Zip | 48864-2563
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Country | US
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Telephone | 218-839-9466
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601011127
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License Number State | MI
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