Provider Demographics
NPI:1578940276
Name:BAIK, RUSTY
Entity Type:Individual
Prefix:
First Name:RUSTY
Middle Name:
Last Name:BAIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 STETSON ST
Mailing Address - Street 2:SUITE 3200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2498
Mailing Address - Country:US
Mailing Address - Phone:513-558-5190
Mailing Address - Fax:513-558-3477
Practice Address - Street 1:260 STETSON ST
Practice Address - Street 2:SUITE 3200
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2498
Practice Address - Country:US
Practice Address - Phone:513-558-5190
Practice Address - Fax:513-558-3477
Is Sole Proprietor?:No
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program