Healthcare Provider Details

I. General information

NPI: 1427443852
Provider Name (Legal Business Name): YORAM SAMUEL BAUM M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2015
Last Update Date: 03/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE H100 EMORY UNIVERSITY HOSPITAL, 1ST FLOOR
ATLANTA GA
30322-1059
US

IV. Provider business mailing address

1364 CLIFTON RD NE H100 EMORY UNIVERSITY HOSPITAL, 1ST FLOOR
ATLANTA GA
30322-1059
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-0093
  • Fax: 404-712-0561
Mailing address:
  • Phone: 404-727-0093
  • Fax: 404-712-0561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number081901
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: