Healthcare Provider Details

I. General information

NPI: 1295723344
Provider Name (Legal Business Name): WILLIAM JOSEPH BAJOREK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 08/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 5 MILE RD SUITE 340
CINCINNATI OH
45230
US

IV. Provider business mailing address

8000 5 MILE RD SUITE 340
CINCINNATI OH
45230-2163
US

V. Phone/Fax

Practice location:
  • Phone: 513-232-8800
  • Fax: 513-232-8802
Mailing address:
  • Phone: 513-232-8800
  • Fax: 513-232-8802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number34-003487
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: