Provider Demographics
NPI:1629002175
Name:SAWMILLER, KAREN M (PAC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:SAWMILLER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:M
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:1035 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2929
Mailing Address - Country:US
Mailing Address - Phone:989-358-0673
Mailing Address - Fax:
Practice Address - Street 1:205 N STATE ST
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:MI
Practice Address - Zip Code:48740-9255
Practice Address - Country:US
Practice Address - Phone:989-724-5655
Practice Address - Fax:989-358-3730
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601004251363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q68426Medicare UPIN