Individual
MICHELLE GITA BAECHTOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 S ROGERS ST, BLOOMINGTON, IN 47403-4792
(812) 339-6434
Mailing address
1200 S ROGERS ST, BLOOMINGTON, IN 47403-4792
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01081864A
IN
Other
Enumeration date
04/06/2015
Last updated
05/19/2023
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