Organization
MARQUETTE GENERAL HOSPITAL, INC.
Active
Other names
Infectious Disease Specialists
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
1414 W FAIR AVE, STE 111, MARQUETTE, MI 49855-2675
(906) 225-7601
(906) 225-7453
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-7601
(906) 225-7453
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E21008
BCBSM GROUP NUMBER
MI
01
—
CH9239
RAILROAD MEDICARE
MI
Enumeration date
05/01/2006
Last updated
04/23/2009
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