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GREAT LAKES ALLERGY AND ASTHMA CENTER P.C. NPI 1912189457


NPI Information

NPI: 1912189457
Provider Name: GREAT LAKES ALLERGY AND ASTHMA CENTER, P.C.
Classification: Internal Medicine - 207RA0201X
Entity Type: Organization

Specialization: Allergy & Immunology

Address:
309 W 12TH AVE
SUITE 101
SAULT SAINTE MARIE, MI
ZIP 49783
Phone: (906) 253-0400
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GREAT LAKES ALLERGY AND ASTHMA CENTER, P.C. is an allergy and immunology internal medicine in Sault Sainte Marie, MI. The provider is an internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology. GREAT LAKES ALLERGY AND ASTHMA CENTER, P.C. NPI is 1912189457. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

309 W 12TH AVE
SUITE 101
SAULT SAINTE MARIE, MI
ZIP 49783-885
Phone: (906) 253-0400

The provider's authorized official is Peter Mike Ranta .
The authorized official title is Owner; Physician and has the following contact phone number (906) 253-0400.

The enumeration date for this NPI number is 11/27/2007 and was last updated on 2/25/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RA0201XInternal MedicineAllergy & Immunology4301082835MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1I06942MEDICARE UPINMICHIGAN
24609268MEDICAIDMICHIGAN
30N91630MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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