Healthcare Provider Details

I. General information

NPI: 1063320661
Provider Name (Legal Business Name): RACHEL RENEE BAUR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 TELEGRAPH RD
TAYLOR MI
48180-3330
US

IV. Provider business mailing address

19444 IRONWOOD DR
MACOMB MI
48042-6021
US

V. Phone/Fax

Practice location:
  • Phone: 313-295-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: