Gastroenterology Specialists of Marquette, PLLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

4301082866 Issued in MI

Legal business name

GASTROENTEROLOGY SPECIALISTS OF MARQUETTE, PLLC

Practice address

580 W College Ave
Marquette, MI 49855-2705

Phone

(906) 225-3680

Fax

(906) 225-4815

NPI assigned

Mar 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. William G Stahl,III

Title

President

Phone

(906) 225-3680

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1962521476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 US HIGHWAY 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552252",
            "telephone_number": "906-225-3964",
            "fax_number": "906-226-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W COLLEGE AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552705",
            "telephone_number": "906-225-3680",
            "fax_number": "906-225-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY SPECIALISTS OF MARQUETTE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "STAHL,III",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-225-3680",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301082866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "1005210961",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "0521096",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4994550",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Brisbane Garde
• Morgan Jean-Peterson Gardner, BCBA - LBA
• Meghan Garrett
• Joanne C. Garrow, LMSW, CAADC
• Sherry Garwood, M.A. CCC-SLP
• Mark S Geissler, M.D.
• Nelson Eric Gencheff, DO
• George Bonefeld PLLC
• Jeffrey F Gephart, MD
• Cassandra Gertjejansen

• Gastroenterology Physician in Marquette, MI
• Providers in Marquette, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.