Great Lakes Radiation Medicine PC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

GREAT LAKES RADIATION MEDICINE PC

Practice address

420 W Magnetic Street
Marquette, MI 49855

Phone

(906) 228-9440

Fax

(906) 225-3772

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Paul O Thieme, DO

Title

President

Phone

(906) 228-9440

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1437218609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W MAGNETIC STREET",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-228-9440",
            "fax_number": "906-225-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MAGNETIC STREET",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-228-9440",
            "fax_number": "906-225-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES RADIATION MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "THIEME",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-228-9440",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Graci, LLMSW
• Caleb Grams
• David Christian Grant, MD
• Alexandra H Gray
• Alyssa Gray, LMSW
• Great Lakes Recovery Center
• Great Lakes Recovery Centers
• Great Lakes Recovery Centers
• Great Lakes Recovery Centers
• Great Lakes Recovery Centers

• Radiation Oncology Physician in Marquette, MI
• Providers in Marquette, MI by specialty
• Radiation Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.