| Doctor Name: | DR. WALTER MICHAEL BAKUN |
| NPI Number: | 1093812539 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MA45488 |
| Business Practice Address: | 59 Koch Ave Morris Plains, NJ - 079504400 |
| Business Phone Number: | 9735391800 |
| Business Fax Number: | 9738898789 |
| Mailing Address: | 59 Koch Ave, MORRIS PLAINS |
| State: | NJ |
| Postal Code: | 079504400 |
| Phone Number: | 9735381800 |
| Fax Number: | 9738898789 |
| NPI Enumeration Date: | 09/19/2006 |
| NPI Last Update Date: | 02/25/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | MA45488 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |