Provider Demographics
NPI:1073999520
Name:STEVEN BAAK, MD LLC
Entity Type:Organization
Organization Name:STEVEN BAAK, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BAAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-942-6464
Mailing Address - Street 1:3440 DE PAUL LN
Mailing Address - Street 2:SUITE 113
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-3545
Mailing Address - Country:US
Mailing Address - Phone:314-942-6464
Mailing Address - Fax:314-492-4636
Practice Address - Street 1:3440 DE PAUL LN
Practice Address - Street 2:SUITE 113
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-3545
Practice Address - Country:US
Practice Address - Phone:314-942-6464
Practice Address - Fax:314-492-4636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105235207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty