Organization
MARQUETTE GENERAL HOSPITAL, INC.
Active
Other names
U.P. INTERNAL MEDICINE ASSOCIATES
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 344, MARQUETTE, MI 49855-2675
(906) 225-3910
(906) 225-4529
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-3910
(906) 225-4529
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RN0300X
Nephrology Physician
—
—
207RR0500X
Rheumatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E20995
BCBSM NEPHROLOGY GRP
MI
01
—
0E21002
BCBS GROUP
MI
01
—
CA1145
RAILROAD MEDICARE
MI
01
—
CB0539
RAILROAD MEDICARE
MI
01
—
CB9574
RAILROAD MEDICARE
MI
Enumeration date
04/27/2006
Last updated
04/23/2009
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