Individual
DR. JILLIAN DIANE DAVIS-BAUMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
15855 NINTEEN MILED ROAD, EMERGENCY DEPT, CLINTON TOWNSHIP, MI 48038-3504
(586) 263-2601
(586) 263-2589
Mailing address
38935 ANN ARBOR RD, CREDENTIALING DEPT, LIVONIA, MI 48150-3397
(734) 805-0488
(866) 250-6385
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101018413
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12551412
CAQH
MI
Enumeration date
11/10/2009
Last updated
09/25/2013
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