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Organization

BALDWIN FAMILY HEALTH CARE

Active
Other names
Family Health Care Grant
Organization subpart
No

Provider details

NPI number
Authorized official
JULIE TATKO (CEO)
(231) 745-2743
Entity
Organization

Contact information

Practice address
11 N MAPLE ST, GRANT, MI 49327-7900
(231) 834-0444
(231) 834-0200
Mailing address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-4624
(231) 745-5031

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0D36000
BCBS
MI
01
700D360000
BCN
MI
Enumeration date
08/30/2006
Last updated
11/12/2020
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