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1811988959

NPI Code Detail

MEDICARE: DR. MICHELLE R STORMS MD

MEDICARE: DR. MICHELLE R STORMS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301077068	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080159930	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811988959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE R STORMS MD

Provider Business Mailing Address
First Line	:	1401 PRESQUE ISLE AVE
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-2818
Country	:	US
Telephone Number	:	906-227-2355
Fax Number	:	906-227-2332

Provider Business Practice Location Address
First Line	:	1401 PRESQUE ISLE AVE
Second Line	:	ATTN: HEALTH CENTER
City	:	MARQUETTE
State	:	MI
Zip	:	49855-2818
Country	:	US
Telephone Number	:	906-227-2355
Fax Number	:	906-227-2332

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	06/24/2012

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Directions to “ DR. MICHELLE R STORMS MD” Practice Location

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