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Organization

TINA PICKETT BAISDEN MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TINA G PICKETT BAISDEN MD (PRESIDENT)
(248) 433-3803
Entity
Organization

Contact information

Practice address
31500 TELEGRAPH RD, SUITE 130, BINGHAM FARMS, MI 48025-4367
(248) 433-3803
(248) 433-3452
Mailing address
PO BOX 250433, FRANKLIN, MI 48025-0433
(248) 433-3803

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
TP057574
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070015591
RAILROAD MEDICARE
MI
01
0706359621
BCBS MI
MI
Enumeration date
05/01/2008
Last updated
06/14/2012
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