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General NPI Number Information
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NPI Number | 1710941935
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Entity Type | Organization
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Legal Business Name | MARQUETTE GENERAL HOSPITAL, INC.
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 580 W COLLEGE AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-2705
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Country | US
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Telephone | 906-225-3985
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Fax | 906-225-4562
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Provider Business Mailing Address
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Address Line | 4602 DEPT
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City | CAROL STREAM
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State | IL
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Zip | 60122-4602
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Country | US
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Telephone | 926-225-3985
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Fax | 906-225-4562
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. A. GARY MULLER
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Credential |
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Telephone | 906-225-4821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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