Healthcare Provider Details

I. General information

NPI: 1043911449
Provider Name (Legal Business Name): MARLETTE REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2771 ANGLE ST
MARLETTE MI
48453-1002
US

IV. Provider business mailing address

2770 MAIN ST
MARLETTE MI
48453-1141
US

V. Phone/Fax

Practice location:
  • Phone: 989-635-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELA MCCONNACHIE
Title or Position: CEO
Credential:
Phone: 989-635-4000