Organization
GASTROENTEROLOGY SPECIALISTS OF MARQUETTE, PLLC
Active
Organization
GASTROENTEROLOGY SPECIALISTS OF MARQUETTE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM G STAHL,III (PRESIDENT)
(906) 225-3680
Entity
Organization
Contact information
Practice address
580 W COLLEGE AVE, MARQUETTE, MI 49855-2705
(906) 225-3680
(906) 225-4815
Mailing address
2837 US HIGHWAY 41 W, MARQUETTE, MI 49855-2252
(906) 225-3964
(906) 226-3875
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301082866
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0521096
BLUE CROSS BLUE SHIELD MI
MI
01
—
1005210961
BLUE CROSS BLUE SHIELD MI
MI
05
—
4994550
—
MI
Enumeration date
03/28/2007
Last updated
08/18/2008
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