MEDICARE: DOCTORS SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	5101006586	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356316186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS SERVICES INC

Provider Business Mailing Address
First Line	:	802 S MAIN ST
Second Line	:	STE 3
City	:	CHEBOYGAN
State	:	MI
Zip	:	49721-2269
Country	:	US
Telephone Number	:	231-627-3002
Fax Number	:	231-627-6204

Provider Business Practice Location Address
First Line	:	802 S MAIN ST
Second Line	:	STE 3
City	:	CHEBOYGAN
State	:	MI
Zip	:	49721-2269
Country	:	US
Telephone Number	:	231-627-3002
Fax Number	:	231-627-6204

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RODERICK JAY BALTZER
Credential	:	DO
Telephone Number	:	231-627-3002

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	10/02/2007

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Directions to “DOCTORS SERVICES INC ” Practice Location

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