Provider Demographics
NPI:1184796039
Name:BAXTER, DANIEL CHARLES (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHARLES
Last Name:BAXTER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:168 S HOWELL ST
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-2040
Mailing Address - Country:US
Mailing Address - Phone:586-268-8440
Mailing Address - Fax:586-268-1911
Practice Address - Street 1:451 HIDDEN MEADOWS DR STE 260
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-9812
Practice Address - Country:US
Practice Address - Phone:517-437-5350
Practice Address - Fax:517-437-8328
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101012541208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF58734Medicare UPIN