Provider Demographics
NPI:1750463071
Name:BAUER, MICHELLE M (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:M
Last Name:BAUER
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1640 FORT ST
Mailing Address - Street 2:SUITE D ATTN DENISE
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2040
Mailing Address - Country:US
Mailing Address - Phone:734-391-3057
Mailing Address - Fax:734-391-3052
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:833-471-3118
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-02-22
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Provider Licenses
StateLicense IDTaxonomies
MI5101013073207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H27501OtherBLUE CROSS
MI0H27501OtherBLUE CROSS
G97831Medicare UPIN