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General NPI Number Information
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NPI Number | 1366654220
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Entity Type | Organization
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Legal Business Name | IRON COUNTY INTERNAL MEDICINE ASSOCIATES, PC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 417 WASHINGTON AVE
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City | IRON RIVER
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State | MI
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Zip | 49935-2214
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Country | US
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Telephone | 906-265-9908
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Fax | 906-265-5921
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Provider Business Mailing Address
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Address Line | 417 WASHINGTON AVE
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City | IRON RIVER
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State | MI
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Zip | 49935-2214
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Country | US
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Telephone | 906-265-9908
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Fax | 906-265-5921
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Authorized Official
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Title or Position | PRESIDENT PHYSICIAN
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Name | DR. ROBERT F HAN
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Credential | MD
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Telephone | 906-265-9908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301038494
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License Number State | MI
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