Provider Demographics
NPI:1366407397
Name:SAGE, JOSEPH G (DO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:G
Last Name:SAGE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2093 HEALTH DR SW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-9691
Mailing Address - Country:US
Mailing Address - Phone:616-532-8100
Mailing Address - Fax:616-532-8200
Practice Address - Street 1:2093 HEALTH DR SW
Practice Address - Street 2:SUITE 300
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-9691
Practice Address - Country:US
Practice Address - Phone:616-532-8100
Practice Address - Fax:616-532-8200
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2008-06-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI51010073522086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1366407397Medicaid
MIP28880004Medicare PIN