| Terry Scott Baul, M.D., P.C. | |
|
17751 E Warren Ave Detroit MI 48224-1329 | |
| (313) 885-6833 | |
| (313) 885-1268 |
| Full Name | Terry Scott Baul, M.D., P.C. |
|---|---|
| Speciality | General Practice |
| Location | 17751 E Warren Ave, Detroit, Michigan |
| Authorized Official Name and Position | Terry Scott Baul (OWNER) |
| Authorized Official Contact | 3138856833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Terry Scott Baul, M.D., P.C. 17751 E Warren Ave Detroit MI 48224-1329 Ph: (313) 885-6833 | Terry Scott Baul, M.D., P.C. 17751 E Warren Ave Detroit MI 48224-1329 Ph: (313) 885-6833 |
| NPI Number | 1619238490 |
|---|---|
| Provider Enumeration Date | 06/07/2012 |
| Last Update Date | 06/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619238490 | NPI | - | NPPES |
| 1624055 | Medicaid | MI | |
| 0821263 | Other | MI | BCBSM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 4301042171 (Michigan) | Primary |
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