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General NPI Number Information
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NPI Number | 1306837083
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Entity Type | Individual
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Provider Name | LEE D BAYLIS MD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 08/20/2007
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Provider Practice Location Address
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Address Line | 5825 S MAIN ST SUITE 203
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City | CLARKSTON
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State | MI
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Zip | 48346-2983
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Country | US
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Telephone | 248-625-7717
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Fax |
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Provider Business Mailing Address
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Address Line | 5825 S MAIN ST SUITE 203
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City | CLARKSTON
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State | MI
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Zip | 48346-2983
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Country | US
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Telephone | 248-625-7717
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Fax | 248-625-5849
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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 | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | 4301061396
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 4301061396
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License Number State | MI
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