Sandra R Richards, N.P.
Individual provider Active NPI Family Medicine Physician · Grass Lake, MI
NPI 1194747501 · NPPES record last updated Oct 4, 2010
Key facts
- NPI
- 1194747501
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4704091343 (MI)
- Practice address
- 12337 E Michigan Ave
Grass Lake, MI 49240-9213 - Phone
- (517) 522-8403
- Fax
- (866) 957-8356
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704091343 | MI | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4704091343 | MI | Yes |
Addresses
Primary practice location
12337 E Michigan Ave
Grass Lake, MI 49240-9213
Mailing address
12337 E Michigan Ave
Grass Lake, MI 49240-9213
Phone (517) 522-8403
Other providers in Grass Lake, MI
- Positive Mindset Therapy, LLC
- Potocki Pediatric Dentistry PLLC
- Providence Hospital
- Todd R. Raehtz
- Rachel Rice
- Jayna Lynn Sharpley
- Elizabeth Ann Shea
- Ian Shepstone
- Lauren Paige Sibeck
- Thomas Ronald Snider
All providers in Grass Lake, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.