Provider Demographics
NPI:1568559383
Name:ADAMS, SARAH A (PAC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:560 W MITCHELL ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2275
Mailing Address - Country:US
Mailing Address - Phone:231-487-2490
Mailing Address - Fax:231-487-4001
Practice Address - Street 1:560 W MITCHELL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2275
Practice Address - Country:US
Practice Address - Phone:231-487-2490
Practice Address - Fax:231-487-4001
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601004874363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F06160OtherMEDICARE BILL PAY TO
Q72365Medicare UPIN
MIF06016059Medicare PIN