Organization
PROFESSIONAL EMERGENCY CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BAUER MD (CMO)
(734) 632-0175
Entity
Organization
Contact information
Practice address
18101 OAKWOOD BLVD, EMERGENCY MEDICINE DEPARTMENT, DEARBORN, MI 48124-4089
(313) 593-8780
(888) 861-8740
Mailing address
38935 ANN ARBOR RD, LIVONIA, MI 48150-3354
(734) 632-0175
(888) 861-8740
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
MI
208000000X
Pediatrics Physician
—
MI
363A00000X
Physician Assistant
—
MI
363L00000X
Nurse Practitioner
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010Q262940
BCBSMI
MI
05
—
1578568036
—
MI
01
—
700D410740
BCBS
—
01
—
700E014610
BCBS
—
01
—
CC0535
RAILROAD MEDICARE
MI
Enumeration date
06/20/2005
Last updated
07/15/2014
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