Provider Demographics
NPI:1043260706
Name:SALES, CHERYL (DO)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:SALES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 43RD ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49508-5099
Mailing Address - Country:US
Mailing Address - Phone:616-281-1426
Mailing Address - Fax:616-281-1439
Practice Address - Street 1:2060 43RD ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49508-5099
Practice Address - Country:US
Practice Address - Phone:616-281-1426
Practice Address - Fax:616-281-1439
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI006932207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2110567Medicaid
MICS006932OtherBCBS ID NUMBER
MI5410007Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
MI2110567Medicaid