Individual
DR. MARILYNN S. DEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 CEDAR ST, HOUGHTON, MI 49931-1978
(906) 487-1710
(906) 487-9421
Mailing address
1000 CEDAR ST, HOUGHTON, MI 49931-1978
(906) 487-1710
(906) 487-9421
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301056759
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233857
RHC MEDICARE NUMBER
MI
05
—
2668377
—
MI
01
—
4301056759
MI LICENSE NUMBER
MI
Enumeration date
06/01/2005
Last updated
03/07/2023
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