MEDICARE: DIRK A BAKKER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	4301067471	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881692077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIRK A BAKKER M.D.

Provider Business Mailing Address
First Line	:	1445 SHELDON RD
Second Line	:	SUITE G1
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-2480
Country	:	US
Telephone Number	:	616-296-9100
Fax Number	:	616-296-0145

Provider Business Practice Location Address
First Line	:	1445 SHELDON RD
Second Line	:	SUITE G1
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-2480
Country	:	US
Telephone Number	:	616-296-9100
Fax Number	:	616-296-0145

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	03/29/2016

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