Individual
JEAN R BASTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3502 W ROGERS AVE, SUITE 1, BALTIMORE, MD 21215-4749
(410) 578-4340
(410) 578-4342
Mailing address
3502 W ROGERS AVE, SUITE 1, BALTIMORE, MD 21215-4749
(410) 578-4340
(410) 578-4342
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0032090
MD
Other
Enumeration date
03/11/2009
Last updated
03/11/2009
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