Healthcare Provider Details

I. General information

NPI: 1821081068
Provider Name (Legal Business Name): DR VM BAICH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date: 05/08/2007
Reactivation Date: 05/21/2007

III. Provider practice location address

101 BAICH DR
COLERAINE MN
55722
US

IV. Provider business mailing address

PO BOX 198 101 BAICH DR
COLERAINE MN
55722-0198
US

V. Phone/Fax

Practice location:
  • Phone: 218-245-1484
  • Fax: 218-245-1522
Mailing address:
  • Phone: 218-245-1484
  • Fax: 218-245-1522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20782
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number20782
License Number StateMN

VIII. Authorized Official

Name: DR. MICHAEL VELEMIR BAICH
Title or Position: PRESIDENT
Credential: DR
Phone: 218-245-1484