Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 4301082835 | MI |
NPI | 1750335378 |
---|---|
Provider Name | Dr. Peter Mike Ranta |
First Address | Sault Sainte Marie, MI 49783-2885 |
Second Address | Sault Sainte Marie, MI 49783-2885 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 05/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4609268 | (05) | MI |
I06942 | (02) |