Provider Demographics
NPI:1508127952
Name:WILCHOWSKI, SARA M (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:WILCHOWSKI
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9016
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:2601 COOLIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6381
Practice Address - Country:US
Practice Address - Phone:517-203-3000
Practice Address - Fax:517-203-3003
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2021-09-21
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Provider Licenses
StateLicense IDTaxonomies
MI1104459363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical