Provider Demographics
NPI:1063233492
Name:RA2 PC
Entity type:Organization
Organization Name:RA2 PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMERGENCY MEDICINE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:AMSTERBURG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:912-532-9907
Mailing Address - Street 1:1920 STURGEON VALLEY RD E
Mailing Address - Street 2:
Mailing Address - City:VANDERBILT
Mailing Address - State:MI
Mailing Address - Zip Code:49795-9751
Mailing Address - Country:US
Mailing Address - Phone:912-532-9907
Mailing Address - Fax:
Practice Address - Street 1:81 S I 75 BUSINESS LOOP
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-7405
Practice Address - Country:US
Practice Address - Phone:989-348-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care