Mark J Rajewski, D.D.S.
Individual provider Active NPI Dentist · Baldwin, MI
NPI 1740539873 · NPPES record last updated Oct 3, 2013
Key facts
- NPI
- 1740539873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2901020718 (MI)
- Practice address
- 1615 Michigan Ave
Baldwin, MI 49304-7984 - Phone
- (231) 745-2743
- NPI assigned
- Sep 5, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121112000015 | MI | Practitioner - Oral Surgery | 7113178666 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L2262929 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baldwin Family Health Care | Current |
Accepting new patients | |
| Baldwin Family Health Care | Current |
Accepting new patients | |
| Baldwin Family Health Care | Current | Accepting new patients |
Locations
1615 Michigan Ave
Baldwin, MI 49304
Phone (231) 745-2781
520 Cobb St
Cadillac, MI 49601
Phone (231) 775-6521
Interoperability endpoints
- mark.rajewski.1@17288.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | L2262929 | MI | |
| Dentist | 122300000X | 2901020718 | MI | Yes |
Addresses
Primary practice location
1615 Michigan Ave
Baldwin, MI 49304-7984
Mailing address
1615 Michigan Ave
Baldwin, MI 49304-7984
Phone (231) 745-2743
Other providers in Baldwin, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.