| Organization Name: | TERRY SCOTT BAUL, M.D., P.C. |
| NPI Number: | 1619238490 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRY SCOTT BAUL (OWNER) |
| Mailing Address: | 17751 E Warren Ave Detroit |
| State: | MI US |
| Postal Code: | 482241329 |
| Phone Number: | 3138856833 |
| Fax Number: | 3138851268 |
| NPI Enumeration Date: | 06/07/2012 |
| NPI Last Update Date: | 06/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301042171 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |