Individual
MARIE G GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
515 MULHOLLAND ST, BAY CITY, MI 48708-7644
(989) 892-3541
(989) 892-5336
Mailing address
515 MULHOLLAND ST, BAY CITY, MI 48708-7644
(989) 892-3541
(989) 892-5336
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301044702
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400900151
BCBSM PIN
MI
01
—
0987594
HEALTHPLUS PROVIDER ID
MI
05
—
1405068
—
MI
Enumeration date
10/27/2005
Last updated
06/21/2010
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