Organization
WEST BRANCH PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNIE C BAKER MD (OWNER)
(989) 343-9466
Entity
Organization
Contact information
Practice address
337 EAST HOUGHTON AVE, WEST BRANCH, MI 48661
(989) 343-9466
(989) 343-9443
Mailing address
PO BOX 295, 337 EAST HOUGHTON AVE, WEST BRANCH, MI 48661
(989) 343-9466
(989) 343-9443
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301085011
MI
208000000X
Pediatrics Physician
Primary
4301085012
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4721025
—
MI
05
—
4735460
—
MI
Enumeration date
02/22/2006
Last updated
08/22/2020
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