Organization Name: | BACCARI PC |
NPI Number: | 1255548814 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELSI MARIA BACCARI (HEAD PHYSICIAN) |
Mailing Address: | 3390 I-75 Business Spur S Soo Plaza Sault Sainte Marie |
State: | MI US |
Postal Code: | 497831014 |
Phone Number: | 9066359710 |
Fax Number: | 9066359780 |
NPI Enumeration Date: | 05/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 5101009526 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |