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Individual

DR. HAN-SOO BAE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
321 STEWART RD, MONROE, MI 48162-4393
(734) 243-5020
(734) 457-1970
Mailing address
321 STEWART RD, MONROE, MI 48162-4393
(734) 243-5020
(734) 457-1970

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301075954
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0405810152
BLUE SHIELD
MI
05
4568755
MI
01
N84640002
PECOS
Enumeration date
05/12/2006
Last updated
04/16/2021
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