Mikala Rae Gualtieri, PA is a
Physician Assistant physician based in Norton Shores, Michigan. Mikala Rae Gualtieri is licensed to practice in Michigan (license number 5601012938) and her current practice location is 3570 Henry St Ste 120, Norton Shores, Michigan. She can be reached at her office (for appointments etc.) via phone at
(231) 672-7000.
NPI number for Mikala Rae Gualtieri is 1669280384 and her current mailing address is 892 College Ave, Holland, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1669280384.
Physician's Profile
Full Name | Mikala Rae Gualtieri |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 3570 Henry St Ste 120, Norton Shores, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1669280384
- Provider Enumeration Date: 12/27/2024
- Last Update Date: 01/14/2025
Medical Identifiers
Medical identifiers for Mikala Rae Gualtieri such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1669280384 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 5601012938APP24 (Michigan) | Secondary |
363A00000X | Physician Assistant | 5601012938 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mikala Rae Gualtieri is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mikala Rae Gualtieri, PA 892 College Ave, Holland, MI 49423-7050 Ph: (616) 510-6407 | Mikala Rae Gualtieri, PA 3570 Henry St Ste 120, Norton Shores, MI 49441-4576 Ph: (231) 672-7000 |
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