Organization
MARQUETTE GENERAL HOSPITAL, INC.
Active
Other names
Marquette General Urology
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, SUITE 249, MARQUETTE, MI 49855-2675
(906) 225-3893
(906) 225-4893
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-4821
(906) 225-4537
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E21094
BCBSM
MI
Enumeration date
09/13/2007
Last updated
04/23/2009
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