Organization
M-15 FAMILY MEDICAL CENTER P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY J. BAYLIS D.O. (PRESIDENT)
(248) 625-5885
Entity
Organization
Contact information
Practice address
7736 ORTONVILLE RD, SUITE A, CLARKSTON, MI 48348-4483
(248) 625-5885
(248) 625-6794
Mailing address
7736 ORTONVILLE RD, SUITE A, CLARKSTON, MI 48348-4483
(248) 625-5885
(248) 625-6794
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101011488
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080127004
MEDICARE RAILROAD
MI
01
—
5630195
BCBS
MI
Enumeration date
02/20/2006
Last updated
07/01/2008
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