Organization
HIAWATHA MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS A LORANCE MD (DIRECTOR)
(906) 387-4996
Entity
Organization
Contact information
Practice address
1510 SANDPOINT RD, SUITE 1, MUNISING, MI 49862-1406
(906) 387-4996
(906) 387-4999
Mailing address
1510 SANDPOINT RD, SUITE 1, MUNISING, MI 49862-1406
(906) 387-4996
(906) 387-4999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301062384
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200200012
BCBS
MI
05
—
2988438
—
MI
01
—
P79059
BLUE CARE NETWORK
MI
Enumeration date
11/15/2006
Last updated
08/22/2020
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