Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | D0075307 | MD |
NPI | 1023093812 |
---|---|
Provider Name | Rebecca Baczuk |
First Address | Arnold, MD 21012-1054 |
Second Address | Arnold, MD 21012-1054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 30/04/2020 |