Provider Demographics
NPI:1194760058
Name:ERCUM - KRASINSKI, BAIBA (MD)
Entity type:Individual
Prefix:DR
First Name:BAIBA
Middle Name:
Last Name:ERCUM - KRASINSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 STUDENT UN
Mailing Address - Street 2:OKLAHOMA STATE UNIVERSITY
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74078-7050
Mailing Address - Country:US
Mailing Address - Phone:405-744-5472
Mailing Address - Fax:405-744-8380
Practice Address - Street 1:320 STUDENT UN
Practice Address - Street 2:OKLAHOMA STATE UNIVERSITY
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74078-7050
Practice Address - Country:US
Practice Address - Phone:405-744-5472
Practice Address - Fax:405-744-8380
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK171742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK17174OtherMEDICAL LICENSE