GREAT LAKES ALLERGY AND ASTHMA CENTER, P.C. (NPI# 1912189457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912189457 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES ALLERGY AND ASTHMA CENTER, P.C. |
| Practice Address |
309 W 12th Ave Suite 101 Sault Sainte Marie MI 49783-2885 |
| Practice Telephone | 9062530400 |
| Mailing Telephone | 9062530400 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2008-02-25 |
| Authorized Official Name | DR. PETER MIKE RANTA (OWNER; PHYSICIAN) |
| Authorized Official Telephone | 9062530400 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0201X |
Internal Medicine Specialization: Allergy & Immunology |
4301082835 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4609268 | 05 |
| Street Address |
309 W 12TH AVE SUITE 101 |
| City | SAULT SAINTE MARIE |
| State | MI |
| Zip Code | 49783-2885 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750335378 | Peter Mike Ranta | Internal Medicine | 309 W 12th Ave, Suite 101, Sault Sainte Marie, MI 49783-2885 | 2006-05-19 |
| 1447615026 | Jagannathan Neurosurgical Institute Pllc | Neurological Surgery | 309 W 12th Ave, Suite 102, Sault Sainte Marie, MI 49783-2886 | 2015-12-23 |
| 1396978086 | Allen B. Dunning Md PC | Specialist | 309 W 12th Ave, Ste 102, Sault Sainte Marie, MI 49783-2885 | 2009-08-27 |
| 1144300724 | Kevin Jon Lawson Md PC | Specialist | 309 W 12th Ave, Suite 102, Sault Sainte Marie, MI 49783-2886 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215541305 | Kevin P Cooper Dds PC | Dentist | 202 Brady Street, Sault Sainte Marie, MI 49783 | 2020-09-04 |
| 1033767512 | Louis William Bergman | Pharmacist | 3763 75 Business Spur, Sault Ste Marie, MI 49783 | 2019-08-28 |
| 1972076818 | Phyllis Mary Robertson | Speech-Language Pathologist | 2472 Ashmun Street, War Memorial Hospital Rehabilitation Centre, Sault Sainte Marie, MI 49783 | 2019-01-03 |
| 1831611748 | Thomas Matthew Choponis | Optometrist | 128 W Spruce St Ste 1, Sault Sainte Marie, MI 49783 | 2017-07-12 |
| 1730633223 | Holly D Statt | Dental Hygienist | 905 Marquette Ave, Sault Sainte Marie, MI 49783 | 2016-08-12 |
| 1316306590 | Debra Joyce Peake | Social Worker | 3865 South Mackinac Trail, Sault Ste Marie, MI 49783 | 2016-02-17 |
| 1629465935 | Jodi Johnson | Occupational Therapy Assistant | 1011 Merridian St, Sault Saint Marie, MI 49783 | 2015-04-24 |
| 1972885606 | Elizabeth Hayes | Social Worker | 3865 S Mackinac Trail, Sault Ste Marie, MI 49783 | 2011-09-20 |
| 1922252618 | Denise L. Montgomery | Registered Nurse | 500 Osborn Blvd., Sault Ste Marie, MI 49783 | 2008-11-08 |
| 1487829826 | Melanie A Cook | Eyewear Supplier (Equipment, not the service) | 1908 Ashman Street, Sault Ste Marie, MI 49783 | 2008-04-28 |
| Find all providers in zip 49783 | ||||
| Taxonomy Code | 207RA0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Allergy & Immunology |
| An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750335378 | Peter Mike Ranta | Internal Medicine | 309 W 12th Ave, Suite 101, Sault Sainte Marie, MI 49783-2885 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770704454 | Louis Alfred Petrucco | Internal Medicine | 9966 Hawthorne Glen Dr, Grosse Ile, MI 48138-2100 | 2007-05-01 |
| 1386712578 | Gursharanjit Singh Dhillon | Internal Medicine | 130 Hampton Cir, Suite 150, Rochester Hills, MI 48307-4195 | 2006-12-04 |
| 1184684847 | Michael S Rowe | Internal Medicine | 24120 Meadowbrook Rd, Ste 201, Novi, MI 48375-3407 | 2006-03-27 |
| 1134192560 | Raka Mahajan | Internal Medicine | 23500 Park St, Suite 3, Dearborn, MI 48124-2598 | 2006-02-08 |
| 1124018296 | Jane E Krasnick | Internal Medicine | 37130 Hoover Rd, Suite A, Warren, MI 48093 | 2005-10-28 |
| 1831681113 | Tina Abraham Do Pllc | Internal Medicine | 75 Barclay Cir Ste 205, Rochester Hills, MI 48307-5821 | 2018-06-03 |
| 1376820605 | Ascension St John Hospital | Internal Medicine | 1202 Walton Blvd, Suite 201, Rochester, MI 48307-6917 | 2011-11-15 |
| 1043538549 | Jeffrey Tulin Silver Md PC | Internal Medicine | 6330 Orchard Lake Rd, Suite 110, West Bloomfield, MI 48322-2398 | 2010-05-07 |
| 1134297674 | Edward M. Zoratti | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2006-12-01 |
| 1396818985 | Henry Ford Health System | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2006-11-15 |
| Find all providers with the same taxonomy | ||||
| City | SAULT SAINTE MARIE |
| Zip Code | 49783 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.