Provider Demographics
NPI:1972701464
Name:BAUST, STEVEN J (PA-C)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:J
Last Name:BAUST
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9212 SANDRA PARK RD
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9408
Mailing Address - Country:US
Mailing Address - Phone:410-529-3134
Mailing Address - Fax:
Practice Address - Street 1:550 N BROADWAY
Practice Address - Street 2:SUITE 810 550 BUILDING
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-2020
Practice Address - Country:US
Practice Address - Phone:410-955-8923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0000085363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant