Individual
DR. TINA PICKETT BAISDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 577-5980
Mailing address
400 MACK AVE, DETROIT, MI 48201-2136
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301057574
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070015591
RAILROAD MEDICARE
MI
01
—
0706359621
BCBSM
MI
Enumeration date
08/03/2006
Last updated
12/15/2023
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