Healthcare Provider Details

I. General information

NPI: 1154317451
Provider Name (Legal Business Name): RICHARD ARTHUR BAUM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST RADIOLOGY, BRIGHAM AND WOMEN'S HOSPITAL
BOSTON MA
02115-6110
US

IV. Provider business mailing address

75 FRANCIS ST RADIOLOGY, BRIGHAM AND WOMEN'S HOSPITAL
BOSTON MA
02115-6110
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-7263
  • Fax: 617-277-8331
Mailing address:
  • Phone: 617-732-7263
  • Fax: 617-277-8331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number212797
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: