Provider Demographics
NPI:1366654220
Name:IRON COUNTY INTERNAL MEDICINE ASSOCIATES, PC
Entity Type:Organization
Organization Name:IRON COUNTY INTERNAL MEDICINE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:906-265-9908
Mailing Address - Street 1:417 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:IRON RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49935-2214
Mailing Address - Country:US
Mailing Address - Phone:906-265-9908
Mailing Address - Fax:906-265-5921
Practice Address - Street 1:417 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:IRON RIVER
Practice Address - State:MI
Practice Address - Zip Code:49935-2214
Practice Address - Country:US
Practice Address - Phone:906-265-9908
Practice Address - Fax:906-265-5921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301038494174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1404383Medicaid
MIB43941Medicare UPIN
MI0369866Medicare ID - Type Unspecified