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Organization

MARQUETTE GENERAL HOSPITAL, INC.

Active
Other names
Family Care Doctors
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 36, MARQUETTE, MI 49855-2675
(906) 225-3864
(906) 225-3851
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-3864
(906) 225-3851

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207QS0010X
Sports Medicine (Family Medicine) Physician
208000000X
Pediatrics Physician
030113
MI
2080P0205X
Pediatric Endocrinology Physician
050876
MI
208100000X
Physical Medicine & Rehabilitation Physician
079600
MI
363A00000X
Physician Assistant
5601004570
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0E26000
BCBSM GROUP
MI
01
0E26000P02
PA IN MEDICARE GROUP
MI
01
0N8996004
PA MEDICARE NUMBER
MI
01
C31351
RAILROAD MEDICARE
MI
01
CA1145
RAILROAD MEDICARE
MI
01
CA7435
RAILROAD MEDICARE
MI
01
CI0319
RAILROAD MEDICARE
MI
01
CN8789
RAILROAD MEDICARE
MI
Enumeration date
04/12/2006
Last updated
05/17/2012
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