Hiawatha Medical PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301062384 Issued in MI

Legal business name

HIAWATHA MEDICAL PC

Practice address

1510 Sandpoint Rd
Suite 1
Munising, MI 49862-1406

Phone

(906) 387-4996

Fax

(906) 387-4999

NPI assigned

Nov 15, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas A Lorance, MD

Title

Director

Phone

(906) 387-4996

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124191754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 SANDPOINT RD",
            "address_2": "SUITE 1",
            "city": "MUNISING",
            "state": "MI",
            "postal_code": "498621406",
            "telephone_number": "906-387-4996",
            "fax_number": "906-387-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 SANDPOINT RD",
            "address_2": "SUITE 1",
            "city": "MUNISING",
            "state": "MI",
            "postal_code": "498621406",
            "telephone_number": "906-387-4996",
            "fax_number": "906-387-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIAWATHA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LORANCE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "906-387-4996",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301062384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2988438",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P79059",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0200200012",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Emily Graves, LLMSW
• Great Lakes Recovery Centers
• Paul Walter Haduck, DO
• Rachel M Harmon, LMSW
• Healthquest of Alger County PLC (HealthQuest of Alger County)
• Colin Irish, DO
• Jmsii Chiropractic PC (Munising Family Chiropractic)
• Christian G. Kagey II, P.T.A.
• Robert C Kamp II, PA-C
• Kareem Said MD

• Family Medicine Physician in Munising, MI
• Providers in Munising, 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 Aug 22, 2020; 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.