Healthcare Provider Details

I. General information

NPI: 1942148820
Provider Name (Legal Business Name): SONJA MARIE DWYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 E H ST
IRON MOUNTAIN MI
49801-4792
US

IV. Provider business mailing address

325 E H ST
IRON MOUNTAIN MI
49801-4792
US

V. Phone/Fax

Practice location:
  • Phone: 906-774-3300
  • Fax: 906-779-3107
Mailing address:
  • Phone: 906-774-3300
  • Fax: 906-779-3107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number4704257413
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: