Organization
MARQUETTE GENERAL HOSPITAL, INC.
Active
Other names
Doctors Park Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. A. GARY MULLER (CHIEF EXECUTIVE OFFICER)
(906) 225-4821
Entity
Organization
Contact information
Practice address
2500 7TH AVE S, ESCANABA, MI 49829-1176
(906) 786-4628
(906) 789-4410
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-4533
(906) 225-4537
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B11008
BCBSM GROUP NUMBER
MI
01
—
C31351
RAILROAD MEDICARE
MI
01
—
CA1145
RAILROAD MEDICARE
MI
01
—
CA7435
RAILROAD MEDICARE
MI
01
—
CI0319
RAILROAD MEDICARE
MI
01
—
RR1029
RAILROAD
MI
Enumeration date
05/01/2006
Last updated
04/23/2009
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