Provider Demographics
NPI:1811988959
Name:STORMS, MICHELLE R (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:R
Last Name:STORMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:R
Other - Last Name:STORMS-VAN HOWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1401 PRESQUE ISLE AVE
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2818
Mailing Address - Country:US
Mailing Address - Phone:906-227-2355
Mailing Address - Fax:906-227-2332
Practice Address - Street 1:1401 PRESQUE ISLE AVE
Practice Address - Street 2:ATTN: HEALTH CENTER
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2818
Practice Address - Country:US
Practice Address - Phone:906-227-2355
Practice Address - Fax:906-227-2332
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2012-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077068207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080159930OtherRAILROAD MEDICARE
MI4574055Medicaid
MI4238179Medicaid
MI4273060Medicaid
MI4238179Medicaid
B18323Medicare UPIN