Provider Demographics
NPI:1982810164
Name:BAICH, MICHAEL VELEMIR (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:VELEMIR
Last Name:BAICH
Suffix:
Gender:M
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:PO BOX 198
Mailing Address - Street 2:101 BAICH DR
Mailing Address - City:COLERAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55722-0198
Mailing Address - Country:US
Mailing Address - Phone:218-245-1484
Mailing Address - Fax:218-245-1522
Practice Address - Street 1:101 BAICH DR
Practice Address - Street 2:
Practice Address - City:COLERAINE
Practice Address - State:MN
Practice Address - Zip Code:55722
Practice Address - Country:US
Practice Address - Phone:218-245-1484
Practice Address - Fax:218-245-1522
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20782207Q00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
70140BAOtherPREFERRED ONE
1010219OtherPREFERRED ONE
1700807OtherMEDICA
MN249793000Medicaid
MN249793000Medicaid
70140BAOtherPREFERRED ONE