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Organization
PROFESSIONAL EMERGENCY CARE, PC
Active
Organization
PROFESSIONAL EMERGENCY CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BAUER MD (CMO)
(734) 632-0175
Entity
Organization
Contact information
Practice address
601 PARK ST, HONESDALE, PA 18431-1445
(570) 253-8140
Mailing address
38935 ANN ARBOR RD, LIVONIA, MI 48150-3397
(734) 632-0175
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021006340001
—
PA
01
—
DN0180
RAILROAD MEDICARE
PA
Enumeration date
10/24/2007
Last updated
07/15/2014
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