Provider Demographics
NPI:1073741823
Name:BAUMSTARK, ROBERT E II (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:BAUMSTARK
Suffix:II
Gender:M
Credentials:DO
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Mailing Address - Street 1:38935 ANN ARBOR RD
Mailing Address - Street 2:CREDENTIALING DEPT
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3397
Mailing Address - Country:US
Mailing Address - Phone:734-805-0488
Mailing Address - Fax:866-250-6385
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48123-4089
Practice Address - Country:US
Practice Address - Phone:313-593-8780
Practice Address - Fax:313-436-2864
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2013-07-10
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Provider Licenses
StateLicense IDTaxonomies
MI5101018274207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
12553298OtherCAQH