Healthcare Provider Details

I. General information

NPI: 1750336624
Provider Name (Legal Business Name): GARY BAUGHMAN DPM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 08/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 LIVINGSTON ST
BAY CITY MI
48708-6392
US

IV. Provider business mailing address

3061 CHRISTY WAY
SAGINAW MI
48603-2267
US

V. Phone/Fax

Practice location:
  • Phone: 989-895-8594
  • Fax:
Mailing address:
  • Phone: 989-791-2455
  • Fax: 989-791-1392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: GARY W BAUGHMAN
Title or Position: PROVIDER
Credential: DPM
Phone: 989-895-8594