Provider Demographics
NPI:1447364237
Name:UEKERT, SARA J (MD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:J
Last Name:UEKERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 PARCHMENT DRIVE SE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546
Mailing Address - Country:US
Mailing Address - Phone:616-949-4840
Mailing Address - Fax:616-949-3531
Practice Address - Street 1:970 PARCHMENT DR SE
Practice Address - Street 2:SUITE 203
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8302
Practice Address - Country:US
Practice Address - Phone:616-949-4840
Practice Address - Fax:616-949-3531
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076495207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0411510OtherBCBSM PIN # INDIVIDUAL
MI110D111480OtherBCBSM GRP PRACTICE #
MI4790971Medicaid
MI0411510OtherBCBSM PIN # INDIVIDUAL
MI4790971Medicaid