Provider Demographics
NPI:1891953352
Name:BAER, MELISSA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:MARIE
Last Name:BAER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 KIMOLE LN
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1491
Mailing Address - Country:US
Mailing Address - Phone:517-264-0590
Mailing Address - Fax:517-264-5728
Practice Address - Street 1:901 KIMOLE LN
Practice Address - Street 2:SUITE A-1
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1491
Practice Address - Country:US
Practice Address - Phone:517-264-0590
Practice Address - Fax:517-264-5728
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN390200000X207V00000X
MI4301099505207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1891953352Medicaid
MI1891953352Medicaid