Organization
BALDWIN FAMILY HEALTH CARE
Active
Parent organization
BALDWIN FAMILY HEALTH CARE
Other names
Baldwin Family Health Care Outreach
Organization subpart
Yes
Provider details
NPI number
Legal business name
BALDWIN FAMILY HEALTH CARE
Authorized official
MRS. JULIE TATKO (PRESIDENT/CEO)
(231) 745-2743
Entity
Organization
Contact information
Practice address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-2736
Mailing address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-2736
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D36000
BCBS
—
Enumeration date
11/04/2015
Last updated
11/12/2020
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