MEDICARE: BAUM PSYCHIATRIC, PLLC

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	2084P0804X	Child & Adolescent Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1205N	OTHER	NC	BCBS OF NC

General Provider Information

NPI Number	:	1922261189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAUM PSYCHIATRIC, PLLC

Provider Business Mailing Address
First Line	:	602 ORCHARD PL
Second Line	:
City	:	HILLSBOROUGH
State	:	NC
Zip	:	27278-8495
Country	:	US
Telephone Number	:	919-732-2897
Fax Number	:

Provider Business Practice Location Address
First Line	:	241 SAINT MARYS RD
Second Line	:
City	:	HILLSBOROUGH
State	:	NC
Zip	:	27278-2521
Country	:	US
Telephone Number	:	919-732-2897
Fax Number	:	919-241-3135

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. STEPHAN FREDRICK BAUM
Credential	:	M.D.
Telephone Number	:	919-732-2897

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	07/08/2008

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