St. Marys Medical Center, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

RG005899 Issued in MI

Legal business name

ST. MARYS MEDICAL CENTER, PC

Practice address

943 E Portage Ave
Sault Sainte Marie, MI 49783-2465

Phone

(906) 632-7878

NPI assigned

Feb 27, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert James Graham, DO

Title

President

Phone

(906) 632-7878

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1104066315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 E PORTAGE AVE",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497832465",
            "telephone_number": "906-632-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 E PORTAGE AVE",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497832465",
            "telephone_number": "906-632-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARYS MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-27",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-632-7878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "RG005899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2786942",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacey N Solloway, PHARMD
• Kevin Sorah, DO
• Brenna Marie Spencer-Castanon
• Karen Ann Sprague
• Sarah St Amour
• Sommer Stallman, LPC
• Bobbie Lee Stark
• Holly D Statt, BS, RDH
• Steven Tommy Staznik, RPH
• Alissa Steele, PA-C

• Family Medicine Physician in Sault Sainte Marie, MI
• Providers in Sault Sainte Marie, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.