Provider Demographics
NPI:1952605503
Name:PENNY S. BAUMEIER DO PLLC
Entity type:Organization
Organization Name:PENNY S. BAUMEIER DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAUMEIER DO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-229-7257
Mailing Address - Street 1:8548 W GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-2326
Mailing Address - Country:US
Mailing Address - Phone:810-229-7257
Mailing Address - Fax:810-229-4069
Practice Address - Street 1:8548 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-2326
Practice Address - Country:US
Practice Address - Phone:810-229-7257
Practice Address - Fax:810-229-4069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012625208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty