Provider Demographics
NPI:1588837975
Name:CHERYL SALES, D.O., P.C.
Entity Type:Organization
Organization Name:CHERYL SALES, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:616-281-1426
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI006932207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2110567Medicaid
MI5410007Medicare PIN
MIE30825Medicare UPIN