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Organization

GREAT LAKES RADIATION MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL O THIEME DO (PRESIDENT)
(906) 228-9440
Entity
Organization

Contact information

Practice address
420 W MAGNETIC STREET, MARQUETTE, MI 49855
(906) 228-9440
(906) 225-3772
Mailing address
420 W MAGNETIC STREET, MARQUETTE, MI 49855
(906) 228-9440
(906) 225-3772

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary

Other

Enumeration date
12/06/2006
Last updated
12/02/2014
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