Organization
MARQUETTE GENERAL HOSPITAL, INC.
Active
Other names
PEDIATRIC SPECIALISTS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. A. GARY MULLER (CHIEF EXECUTIVE OFFICER)
(906) 225-3925
Entity
Organization
Contact information
Practice address
1414 W FAIR AVE, STE 226, MARQUETTE, MI 49855-2675
(906) 225-3925
(906) 225-4838
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-4533
(906) 225-4537
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E21011
BCBS GROUP
MI
Enumeration date
05/03/2006
Last updated
04/23/2009
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