Individual
JONATHON DAVID BAICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 876-4806
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704293064
MI
163W00000X
Registered Nurse
RN.456957
OH
367500000X
Certified Registered Nurse Anesthetist
0020358
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
4704293064
MI
Other
Enumeration date
06/10/2021
Last updated
08/21/2023
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