Provider Demographics
NPI:1336359462
Name:PLATTE, SARA ANN (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:PLATTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:111 N HURON ST
Mailing Address - Street 2:SUITE #200
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-2676
Mailing Address - Country:US
Mailing Address - Phone:734-547-7977
Mailing Address - Fax:734-547-7978
Practice Address - Street 1:111 N HURON ST
Practice Address - Street 2:SUITE #200
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-2676
Practice Address - Country:US
Practice Address - Phone:734-547-7977
Practice Address - Fax:734-547-7978
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2012-08-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301100267207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILROO229Medicare UPIN