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NPI Code Detail

MEDICARE: MARQUETTE GENERAL HOSPITAL, INC.

MEDICARE: MARQUETTE GENERAL HOSPITAL, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RR1029OTHERMIRAILROAD MEDICARE
2CI0319OTHERMIRAILROAD MEDICARE
3CA1145OTHERMIRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4700C61002OTHERMIBCBSM GROUP

General Provider Information

NPI Number : 1700847977
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARQUETTE GENERAL HOSPITAL, INC.
Provider Business Mailing Address
First Line : 4602 DEPT
Second Line :
City : CAROL STREAM
State : IL
Zip : 60122-0021
Country : US
Telephone Number : 906-225-4533
Fax Number : 906-225-4537
Provider Business Practice Location Address
First Line : 1500 W ICE LAKE RD
Second Line :
City : IRON RIVER
State : MI
Zip : 49935-8509
Country : US
Telephone Number : 906-265-5378
Fax Number : 906-265-6332
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MR. A. GARY MULLER
Credential :
Telephone Number : 906-225-4821
Provider Enumeration Date : 03/29/2006
Last Update Date : 04/23/2009

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Directions to “MARQUETTE GENERAL HOSPITAL, INC. ” Practice Location

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