Organization
MARQUETTE GENERAL HOSPITAL, INC.
Active
Other names
North Shore Internal Medicine
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
2420 1ST AVE S, ESCANABA, MI 49829-1309
(906) 786-1563
(906) 786-8914
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-4821
(906) 225-4537
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301068941
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B11007
BLUE CROSS BLUE SHIELD GR
MI
01
—
CB9574
RAILROAD MEDICARE
MI
01
—
CC6305
RAILROAD MEDICARE
MI
Enumeration date
07/27/2006
Last updated
04/27/2009
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