Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blayne David Baggett

Individual provider Physician Assistant · NPI 1114382637

Blayne David Baggett is a Physician Assistant in Fenton, Michigan. Qualified in 2015, 11 years ago. Practices with Svc Dermatology PC, a 5-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
11
Licensed in
MI
In the registry since
2015

Practice location Address checks out

305 N Leroy St
Fenton, MI 48430-2729
Phone: (810) 629-9200
Fax: (810) 629-9653
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601007628 (MI)

Record details

NPI number1114382637
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 29, 2015
Last updated in NPPESDecember 29, 2015
Mailing address305 N Leroy St, Fenton, MI 48430-2729

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Svc Dermatology Pc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Fenton