MEDICARE: DR. VICTOR A. BAUMGARTEN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CSW002653	GA
2	1041C0700X	Clinical Social Worker	280654-3501	UT

General Provider Information

NPI Number	:	1306038963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR A. BAUMGARTEN PH.D.

Provider Business Mailing Address
First Line	:	PSC 9 BOX 2884
Second Line	:
City	:	APO
State	:	AE
Zip	:	09123-0029
Country	:	US
Telephone Number	:	06565618285
Fax Number	:

Provider Business Practice Location Address
First Line	:	2468 ROARING FORK DR
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-9590
Country	:	US
Telephone Number	:	435-218-3610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	11/28/2024

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