Organization
U. P. DIGESTIVE DISEASE ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL LIUBAKKA CPA (PRACTICE ADMINISTRATOR)
(906) 225-3880
Entity
Organization
Contact information
Practice address
1414 W FAIR AVE, STE 247, MARQUETTE, MI 49855-2675
(906) 225-3880
(906) 225-4523
Mailing address
1414 W FAIR AVE, STE 247, MARQUETTE, MI 49855-2675
(906) 225-3880
(906) 225-4523
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK5977
RAILROAD MEDICARE
MI
Enumeration date
02/14/2007
Last updated
05/07/2012
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