Individual
EMILY A BALTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 325-1000
(248) 325-0623
Mailing address
8401 CHERRY HILL RD, YPSILANTI, MI 48198-9425
(248) 494-1484
(248) 325-0623
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005789
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12131237
CAQH
—
01
—
5820835
BCBSMI
MI
Enumeration date
07/07/2010
Last updated
03/09/2021
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