Individual
HEATHER SPOHN BARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6868
Mailing address
14760 31 MILE RD, WASHINGTON TOWNSHIP, MI 48095-1503
(248) 722-8298
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004284
MI
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1062339
NCCPA CERTIFICATE NUMBER
MI
Enumeration date
05/19/2006
Last updated
03/17/2018
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