DLP Marquette Physician Practices Inc
Organization Active NPI Obesity Medicine (Internal Medicine) Physician · Marquette, MI
NPI 1487902995 · NPPES record last updated May 11, 2023
Key facts
- NPI
- 1487902995
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obesity Medicine (Internal Medicine) Physician 207RB0002X
- Legal business name
- DLP MARQUETTE PHYSICIAN PRACTICES INC
- Practice address
- 1414 W Fair Ave
Ste 36
Marquette, MI 49855-2675 - Phone
- (906) 225-3864
- Fax
- (906) 225-3851
- NPI assigned
- Aug 15, 2012
- Organization subpart
- No
Authorized official
- Name
- Monica Bowman
- Title
- President
- Phone
- (615) 920-7000
Other NPIs on the same Medicare enrollment 33
Other NPIs with the same Medicare PAC ID 3
Practitioners 498
-
Waqas Abid, MD
-
Sheetal Acharya, MD
-
Fadi Antaki, M.D.
-
Paul G Armour, MD
-
Sarah Jean Bannan, NP-C
-
Amanda L Beerman, NP
-
Rachel Bonsall, FNP-BC
-
Melissa A Broeders, P.A.-C
-
Dexter D Clark, DO
-
Lara R Clary-Lantis, D.O.
-
Mark David Cowan, MD
-
Simone Nadeen Cowan, D.O.
-
Ashley E Croasdell, FNP
-
Joel Ryan Dank, MD
-
Aria Darling, MD
-
Alycia Davidson, FNP-C
-
Meghan Nicole Digneit, FNP-C
-
Ericka Marie Distefano, FNP, ACUPUNCTURIST
-
Steven Dowdy, DO
-
Michael F Duckwall, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (6 enrollments) in MI, FL, TX, GA, VA, DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121016000312 | MI | Part B Supplier - Clinic/Group Practice | 9931359601 |
Receives reassigned benefits from 467 practitioners 33 other NPIs on this enrollment Practice locations: Marquette, MI; Negaunee, MI; Newberry, MI; Escanaba, MI; Ontonagon, MI; Sault Sainte Marie, MI; Ternary, MI; Manistique, MI… |
| O20240725001079 | FL | Part B Supplier - Clinic/Group Practice | 9931359601 |
Receives reassigned benefits from 5 practitioners Practice locations: Bonita Springs, FL; Orlando, FL; Ormond Beach, FL; Port St Lucie, FL; Tampa, FL |
| O20240801001201 | TX | Part B Supplier - Clinic/Group Practice | 9931359601 |
Receives reassigned benefits from 3 practitioners Practice locations: Houston, TX; San Antonio, TX; Fort Worth, TX |
| O20240806004425 | GA | Part B Supplier - Clinic/Group Practice | 9931359601 |
Receives reassigned benefits from 7 practitioners Practice locations: Suwanee, GA; Sparks, GA; Mableton, GA; Lawrenceville, GA; Decatur, GA; Atlanta, GA |
| O20240829002671 | VA | Part B Supplier - Clinic/Group Practice | 9931359601 |
Receives reassigned benefits from 2 practitioners Practice locations: Richmond, VA; Yorktown, VA |
| O20240914000136 | DC | Part B Supplier - Clinic/Group Practice | 9931359601 |
Receives reassigned benefits from 3 practitioners 1 other NPI on this enrollment Practice locations: Alexandria, VA; Fairfax, VA; Potomac, MD |
National Provider Directory
Locations
850 W Baraga Ave
Ste 12
Marquette, MI 49855
Phone (906) 449-3360
580 W College Ave
Fl 6
Marquette, MI 49855
1414 W Fair Ave
Ste 250
Marquette, MI 49855
Phone (906) 225-3880
1400 W Washington St
Ofc
Marquette, MI 49855
850 W Baraga Ave
Ste 20
Marquette, MI 49855
Phone (906) 449-3440
1414 W Fair Ave
Ste 35
Marquette, MI 49855
Phone (906) 225-4555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Obesity Medicine (Internal Medicine) Physician |
207RB0002X | Yes | ||
| Hematology & Oncology Physician |
207RH0003X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Pediatrics Physician |
208000000X | |||
| Neurology Physician |
2084N0400X | |||
| Surgery Physician |
208600000X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
1414 W Fair Ave
Ste 36
Marquette, MI 49855-2675
Mailing address
1414 W Fair Ave
Ste 36
Marquette, MI 49855-2675
Phone (906) 225-3864
Other names
- MARQUETTE GENERAL FAMILY MEDICINE - MARQUETTE
Other providers in Marquette, MI
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
All providers in Marquette, MI · Obesity Medicine (Internal Medicine) Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.