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General NPI Number Information
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NPI Number | 1386021582
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Entity Type | Organization
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Legal Business Name | BALDWIN FAMILY HEALTH CARE
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 520 COBB ST
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City | CADILLAC
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State | MI
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Zip | 49601-2588
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Country | US
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Telephone | 231-775-6521
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Fax | 231-876-6519
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Provider Business Mailing Address
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Address Line | 1615 MICHIGAN AVE
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City | BALDWIN
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State | MI
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Zip | 49304-7984
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Country | US
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Telephone | 231-745-4624
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Fax | 231-745-5031
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Authorized Official
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Title or Position | CEO
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Name | JULIE TATKO
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Credential |
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Telephone | 231-745-5057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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