Individual
CHARLENE M BAUMGARTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
400 MEDICAL PARK DR, WATERVLIET, MI 49098-9225
(269) 463-3600
Mailing address
400 MEDICAL PARK DR, WATERVLIET, MI 49098-9225
(269) 463-3600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
CB003338
MI
363AM0700X
Medical Physician Assistant
5601003338
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861466005
—
MI
Enumeration date
02/15/2006
Last updated
11/19/2015
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