Provider Demographics
NPI:1225751720
Name:MICHELLE BAUER DO PLLC
Entity Type:Organization
Organization Name:MICHELLE BAUER DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:833-373-7389
Mailing Address - Street 1:1570 KINGSWAY CT
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1960
Mailing Address - Country:US
Mailing Address - Phone:833-373-7389
Mailing Address - Fax:734-789-9353
Practice Address - Street 1:1570 KINGSWAY CT
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-1960
Practice Address - Country:US
Practice Address - Phone:833-373-7389
Practice Address - Fax:734-789-9353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty