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General NPI Number Information
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NPI Number | 1265662738
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Entity Type | Individual
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Provider Name | DANIELLE ALLYN BAILLARGEON P.A.-C.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2009
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Last Update Date | 07/19/2009
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Provider Practice Location Address
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Address Line | 4100 JOHN R ST
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City | DETROIT
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State | MI
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Zip | 48201-2013
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Country | US
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Telephone | 313-576-8211
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Fax |
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Provider Business Mailing Address
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Address Line | 4180 MITCHELL CRESCENT
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City | WINDSOR
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State | ONTARIO
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Zip | N9G 2G2
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Country | CA
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Telephone | 519-903-4180
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601005489
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License Number State | MI
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