# MICHAEL J BALDECK, DO, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508808049
- **Authorized official:** DR. MICHAEL J BALDECK DO (OWNER/PHYSICIAN)
- **Authorized official phone:** (208) 798-4814

## Contact information

- **Practice address:** 307 SAINT JOHNS WAY, SUITE 4, LEWISTON, ID 83501-2435
- **Practice address phone:** (208) 798-4818
- **Practice address fax:** (208) 798-8711
- **Mailing address:** 307 SAINT JOHNS WAY, SUITE 4, LEWISTON, ID 83501-2435
- **Mailing address phone:** (208) 798-4818
- **Mailing address fax:** (208) 798-8711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0-185 | ID | Yes |

## Other

- **Enumeration date:** 06/11/2006
- **Last updated:** 08/22/2020