Organization
BALDWIN FAMILY HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE TATKO (CEO)
(231) 745-2743
Entity
Organization
Contact information
Practice address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-4624
(231) 745-5031
Mailing address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-4624
(231) 745-5031
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D36000
BCBS
MI
01
—
700D360000
BCN
MI
Enumeration date
08/30/2006
Last updated
11/11/2020
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