Individual
MARILYN L.G. GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
25 MICHIGAN ST NE, SUITE 6100, GRAND RAPIDS, MI 49503-2515
(616) 267-7900
(616) 267-7901
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
4301082971
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
458071310
—
MI
01
—
700H262230
BLUE CROSS-BLUE CROSS
—
01
—
MG082971
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
11/21/2006
Last updated
06/26/2012
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