Healthcare Provider Details

I. General information

NPI: 1811808462
Provider Name (Legal Business Name): HEIDE BAUCHAN LLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 S ELMS RD STE A
SWARTZ CREEK MI
48473-9767
US

IV. Provider business mailing address

5506 MEADOWCREST DR
FLINT MI
48532-4041
US

V. Phone/Fax

Practice location:
  • Phone: 810-285-8429
  • Fax: 810-204-4950
Mailing address:
  • Phone: 810-285-8429
  • Fax: 810-204-4950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: