| Doctor Name: | JUSTIN BAKAIAN |
| NPI Number: | 1376817676 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RD, CNSC |
| License Number: | DI1080 |
| Business Practice Address: | 420 Franklin St Rumford, ME - 042762104 |
| Business Phone Number: | 2073691296 |
| Business Fax Number: | |
| Mailing Address: | 264 Academy Rd, MONMOUTH |
| State: | ME |
| Postal Code: | 042597033 |
| Phone Number: | 2076202179 |
| Fax Number: | 2077537234 |
| NPI Enumeration Date: | 03/05/2012 |
| NPI Last Update Date: | 03/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | DI1080 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |