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Individual

WILLIAM G STAHL III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1414 W FAIR AVE, SUITE 247, MARQUETTE, MI 49855-2675
(906) 225-3880
(906) 225-4523
Mailing address
1414 W FAIR AVE, SUITE 247, MARQUETTE, MI 49855-2675
(906) 225-3880
(906) 225-4523

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301082866
MI
207RG0100X
Gastroenterology Physician
Primary
4301082866
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0521096
BLUE CROSS BLUE SHIELD MI
MI
05
4994550
MI
Enumeration date
05/16/2006
Last updated
01/28/2013
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