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Organization
MARISSA BACA, PLLC
Active
Organization
MARISSA BACA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA BACA MD (OWNER)
(586) 322-2650
Entity
Organization
Contact information
Practice address
32000 TELEGRAPH RD, BINGHAM FARMS, MI 48025-2442
(248) 647-5800
(248) 647-1799
Mailing address
320 N CRANBROOK CROSS RD, BLOOMFIELD HILLS, MI 48301-2765
(586) 322-2650
Taxonomy
Speciality
Code
Description
License number
State
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
—
NULL
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
—
—
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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