Healthcare Provider Details

I. General information

NPI: 1780902056
Provider Name (Legal Business Name): LAURA VAN METRE BAUM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA JENNIFER VAN METRE MD

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROOKLINE AVE
BOSTON MA
02215-5450
US

IV. Provider business mailing address

450 BROOKLINE AVE
BOSTON MA
02215-5450
US

V. Phone/Fax

Practice location:
  • Phone: 617-632-4500
  • Fax: 617-632-5370
Mailing address:
  • Phone: 617-632-4500
  • Fax: 617-632-5370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number267419
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number69240
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number1024392
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number69240
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number69240
License Number StateCT
# 6
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number1024392
License Number StateMA
# 7
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number1024392
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: