| Bakke Medical Pc | |
|
1039 Washington St Dearborn MI 48124-2016 | |
| (313) 563-1033 | |
| (313) 563-2930 |
| Full Name | Bakke Medical Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1039 Washington St, Dearborn, Michigan |
| Authorized Official Name and Position | Daisy S Angeles (PRESIDENT) |
| Authorized Official Contact | 3135631033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bakke Medical Pc 21723 Garrison St Dearborn MI 48124-2368 Ph: (313) 274-4215 | Bakke Medical Pc 1039 Washington St Dearborn MI 48124-2016 Ph: (313) 563-1033 |
| NPI Number | 1265576888 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 02/14/2019 |
| Medicare PECOS PAC ID | 4082700539 |
|---|---|
| Medicare Enrollment ID | O20071016000084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265576888 | NPI | - | NPPES |
| 1361633 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4301037608 (Michigan) | Primary |
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