Provider Demographics
NPI:1780792754
Name:BAUMBICK, ROBERT J (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:BAUMBICK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35095 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:N RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-3018
Mailing Address - Country:US
Mailing Address - Phone:440-353-0707
Mailing Address - Fax:440-353-0252
Practice Address - Street 1:35410 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-3018
Practice Address - Country:US
Practice Address - Phone:440-353-0707
Practice Address - Fax:440-353-0252
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2431111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2009436Medicaid
OH4233621Medicare PIN