Healthcare Provider Details

I. General information

NPI: 1811988959
Provider Name (Legal Business Name): MICHELLE R STORMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE R STORMS-VAN HOWE

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 06/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 PRESQUE ISLE AVE ATTN: HEALTH CENTER
MARQUETTE MI
49855-2818
US

IV. Provider business mailing address

1401 PRESQUE ISLE AVE
MARQUETTE MI
49855-2818
US

V. Phone/Fax

Practice location:
  • Phone: 906-227-2355
  • Fax: 906-227-2332
Mailing address:
  • Phone: 906-227-2355
  • Fax: 906-227-2332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301077068
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: