Organization
GREAT LAKES ALLERGY AND ASTHMA CENTER, P.C.
Active
Organization
GREAT LAKES ALLERGY AND ASTHMA CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER MIKE RANTA M.D. (OWNER; PHYSICIAN)
(906) 253-0400
Entity
Organization
Contact information
Practice address
309 W 12TH AVE, SUITE 101, SAULT SAINTE MARIE, MI 49783-2885
(906) 253-0400
Mailing address
309 W 12TH AVE, SUITE 101, SAULT SAINTE MARIE, MI 49783-2885
(906) 253-0400
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
4301082835
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4609268
—
MI
Enumeration date
11/27/2007
Last updated
02/25/2008
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