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Individual

MARK S GEISSLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1414 W FAIR AVENUE, SUITE 230, MARQUETTE, MI 49855-2675
(906) 225-3853
(906) 228-4065
Mailing address
1414 W FAIR AVENUE, SUITE 230, MARQUETTE, MI 49855-2675
(906) 225-3853
(906) 228-4065

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MG061171
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0523259
BLUE CROSS/BLUE SHIELD
MI
05
2952097
MI
Enumeration date
06/30/2005
Last updated
07/10/2010
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