Basic Information
| Provider Information | |||||||||
| NPI: | 1134322571 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAYUK | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | PAUL | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E MCBEE AVE FL 4 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296012842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645228603 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1012 MEDICAL RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293254542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8648333852 | ||||||||
| FaxNumber: | 8649380501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2007 | ||||||||
| LastUpdateDate: | 08/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | H0072718 | MD | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 2839 | WV | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | H72718 | MD | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 51874 | SC | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | SCC1587628 | 01 | SC | MEDICARE PIN | OTHER | 518746 | 05 | SC | MEDICAID |