Healthcare Provider Details
I. General information
NPI: 1730188202
Provider Name (Legal Business Name): ROBERT BAUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/18/2005
Last Update Date: 02/14/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6435 E BROAD ST
COLUMBUS OH
43213-1507
US
IV. Provider business mailing address
700 CHILDRENS DR
COLUMBUS OH
43205-2664
US
V. Phone/Fax
- Phone: 614-355-8100
- Fax:
- Phone: 614-722-2000
- Fax: 614-722-4380
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 35-069438 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0204X |
| Taxonomy | Pediatric Emergency Medicine (Pediatrics) Physician |
| License Number | 35.069438 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: