Provider Demographics
NPI:1285684704
Name:BAXT, ROBERT STONE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:STONE
Last Name:BAXT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:515 FAIRMOUNT AVE
Mailing Address - Street 2:CREDENTIALING DEPARTMENT
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5466
Mailing Address - Country:US
Mailing Address - Phone:410-494-1324
Mailing Address - Fax:410-494-1361
Practice Address - Street 1:750 MAIN ST
Practice Address - Street 2:SUITE 301
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-2515
Practice Address - Country:US
Practice Address - Phone:410-526-3051
Practice Address - Fax:410-526-3091
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD13335208600000X
MDD0013335208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD252441400Medicaid
MD157676Medicare PIN
MD252441400Medicaid
MD020031476Medicare PIN
MDB66749Medicare UPIN
MD150325ZD2XMedicare PIN