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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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